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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Endoscopic Bleeding Risk - Summary points from ASGE guideline 

Low Risk Procedures 
 - Diagnostic endoscopy
forceps biopsy (EGD ... - Resections (ESD ... Gastroenterology #EGD ... HighRisk #Diagnosis #Management
EGD Nail Removal in the Duodenum
6y M, Hx of 2.5" carpenter's Nail ingestion 3hrs. Very sharp
EGD Nail Removal ... hold from sharp end ... not, trail sharp end ... Removal #Endoscopy #egd ... gastroenterology #retrieval #clinical
Acute Esophageal Necrosis
History: Hematemesis and/or melena (70%), Dysphagia, Epigastric/chest pain, Sepsis
Diagnosis EGD and Biopsy
Differential: Melanosis, Melanoma,
Sepsis Diagnosis EGD ... and Biopsy Differential ... Klebsiella, pneumoniae) Management ... esophagus #diagnosis #management
Forrest Classification for Peptic Ulcer Bleeding
Rebleeding risks are without endoscopic intervention
1a - Spurting Bleed - 60-100%
gastroenterology #EGD ... #clinical
Hepatocellular Carcinoma (HCC) in Cirrhosis - Management Algorithm

Very early (0) - Single <2 cm, Preserved liver
in Cirrhosis - Management ... transplantable HCC, End-stage ... HCC #Cirrhosis #Management
Pancreatic cystic lesions (PCLs)
 - classified into simple retention cysts, pseudocysts and cystic neoplasms 
 -
histological and clinical ... gastroenterology #diagnosis #management ... #differential
Gastric Intestinal Metaplasia (GIM)
 • GIM is a precancerous, histopathologic change characterized by replacement of normal
pylori) gastritis Clinical ... algorithm for GIM management ... GIM #diagnosis #management
Brisk Gastric Bleeding on Upper Endoscopy
87 year old female. Acute bleeding in stomach.  Dieulafoy’s Lesion
Upper #Endoscopy #EGD ... gastroenterology #clinical
Endoscopy - Management of Bleeding Esophageal Varices 
What to Band?
 - Always find the varix that
Endoscopy - Management ... EGD and the Banding ... #Tips #Tricks #management ... fellows #endoscopy #egd
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
evaluation of the clinical ... /or suspicious clinical ... the remainder, a clinical ... elevation and clinical ... Liver #Enzymes #Differential