Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
Causes of Severe ... hepatitis - Acute biliary ... Hemochromatosis - Primary biliary ... Severe #Acute #Causes
Gallstone Diseases
1. Asymptomatic Stones 75%
2. Biliary Pain 20%
3. Acute Cholecystitis 10%
4. Mirizzi's Syndrome < 0.1%
5. Cholangitis/
Biliary Pain 20% ... differential #diagnosis #causes
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
congenital - Primary biliary ... Hepatology #Cirrhosis #Causes
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
for alternative causes ... Benign/malignant biliary ... obstruction, Primary biliary
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary ... inflammation and biliary ... #PBC #Primary #Biliary
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... #PBC #Primary #Biliary
Drugs and Classes Associated with DILI and Type of Liver Injury

#Medications #Differential #DrugInduced #LiverInjury #Hepatology #Pharmacology
Drugs and Classes ... #Pharmacology #Causes
Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
Difficult Selective Biliary ... site - OTHERS: biliary ... #Selective #Biliary
Common Bile Duct Biliary Stone removal on ERCP

Dr. Joaquín Berrueta Mezzera @DrJBerrueta

#Biliary #Stone #removal #extraction #ERCP
Common Bile Duct Biliary ... DrJBerrueta #Biliary
Pancreatic Cyst Diagnosis on Endoscopic Ultrasound EUS
Features of low cancer risk: No symptoms caused by the
risk: No symptoms caused ... risk: Symptoms caused ... such as jaundice, nausea