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 ... #Risks #Gastroenterology ... #EGD #LowRisk # ... HighRisk #Diagnosis #Management
Pancreatic cystic lesions (PCLs)
 - classified into simple retention cysts, pseudocysts and cystic neoplasms 
 -
Pancreatic cystic ... histological and clinical ... lesions #PCLs #gastroenterology ... #diagnosis #management ... #differential
Forrest Classification for Peptic Ulcer Bleeding
Rebleeding risks are without endoscopic intervention
1a - Spurting Bleed - 60-100%
Forrest Classification ... risks are without endoscopic ... Re-bleeding #Forrest ... Risks #Grading #gastroenterology ... #EGD #clinical
Brisk Gastric Bleeding on Upper Endoscopy
87 year old female. Acute bleeding in stomach.  Dieulafoy’s Lesion
Bleeding on Upper Endoscopy ... Bleeding #Upper #Endoscopy ... #EGD #gastroenterology ... #clinical
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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 ... Melanoma, Coal dust, Caustic ... Klebsiella, pneumoniae) Management ... #gastroenterology
EGD Nail Removal in the Duodenum
6y M, Hx of 2.5" carpenter's Nail ingestion 3hrs. Very sharp
EGD Nail Removal ... Nail #Removal #Endoscopy ... #egd #esophagogastroduodenoscopy ... #gastroenterology ... #retrieval #clinical
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Gastric Intestinal Metaplasia (GIM)
 • GIM is a precancerous, histopathologic change characterized by replacement of normal
pylori) gastritis Clinical ... algorithm for GIM management ... Endoscopic surveillance ... GIM #diagnosis #management ... #gastroenterology
Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
to pick up the correct ... malignancy makes the cystic ... Difficult #ercp #gastroenterology ... #management #diagnosis
Endoscopy - Management of Bleeding Esophageal Varices 
What to Band?
 - Always find the varix that
Endoscopy - Management ... EGD and the Banding ... #gastroenterology ... #fellows #endoscopy ... #egd #banding
Antibiotic Prophylaxis for Endoscopy (ASGE 2015) 

Give Antibiotics: 
 - PEG tube placement (or PEG-J)
Prophylaxis for Endoscopy ... or mediastinal cysts ... #EGD #Indications ... #Gastroenterology ... #Management