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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20 results
Acute Esophageal Necrosis
History: Hematemesis and/or melena (70%), Dysphagia, Epigastric/chest pain, Sepsis
Diagnosis EGD and Biopsy
Differential: Melanosis, Melanoma,
Sepsis Diagnosis EGD ... Pseudomembranous esophagitis ... Klebsiella, pneumoniae) Management ... esophagus #diagnosis #management
Eosinophilic Esophagitis (EoE) - Endoscopic ReFerence Score (EREFS)
Edema (Loss of vascular markings):
 - Grade 0: Distinct
Eosinophilic Esophagitis ... #Eosinophilic #Esophagitis ... gastroenterology #EGD
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
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
Refractory Eosinophilic Esophagitis (EOE) Management Algorithm
Initial treatment with topical steroids
Initial treatment with dietary elimination
Continued EoE nonresponse:
Refractory Eosinophilic Esophagitis ... (EOE) Management ... Elemental diet, Clinical ... #Eosinophilic #Esophagitis ... #Management #Algorithm
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
Eosinophilic Esophagitis (EoE) - Treatment Algorithm
Medical therapy:
 • Proton pump inhibition
 • Topical corticosteroids
Diet therapy
 •
Eosinophilic Esophagitis ... #Eosinophilic #Esophagitis ... Treatment #Algorithm #management
Brisk Gastric Bleeding on Upper Endoscopy
87 year old female. Acute bleeding in stomach.  Dieulafoy’s Lesion
Upper #Endoscopy #EGD ... gastroenterology #clinical