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
guideline Low ... forceps biopsy (EGD ... PEG placement (low ... - Resections (ESD ... Gastroenterology #EGD
Pancreatic Cyst Diagnosis on Endoscopic Ultrasound EUS
Features of low cancer risk: No symptoms caused by the
Pancreatic Cyst ... EUS Features of low ... widening of the main pancreatic ... , Widened main pancreatic ... duct #Pancreatic
Causes of Low Vitamin B12 Levels
Low vitamin B12 intake - Vegetarianism, chronic alcoholism and older people
Autoimmune
Causes of Low Vitamin ... B12 Levels Low ... overgrowth, chronic pancreatic ... VitaminB12 #deficiency #low ... #cobalamin #differential
EGD Nail Removal in the Duodenum
6y M, Hx of 2.5" carpenter's Nail ingestion 3hrs. Very sharp
EGD Nail Removal ... • be gentle, slow ... hold from sharp end ... not, trail sharp end ... Removal #Endoscopy #egd
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Overview of Pancreatic Cysts
True Epithelial Cyst
Serous Cystadenoma (SCA)
Mucinous Cystic Neoplasm (MCN)
Intraductal Papillary Mucinous Neoplasm (IPMN)
Cystic Neuroendocrine
Overview of Pancreatic ... Pseudocysts #Pancreatic ... comparison #table #differential
Pancreatic cystic lesions (PCLs)
 - classified into simple retention cysts, pseudocysts and cystic neoplasms 
 -
Pancreatic cystic ... @KM_Pawlak #Pancreatic ... diagnosis #management #differential
Causes of a low fecal elastase
Abnormal pancreatic imaging:
Chronic pancreatitis, Pancreatic tumours including cystic disease, Pancreatic resection,
Causes of a low ... resection, Pancreatic ... malformation (eg ... fecal #elastase #low ... #differential #
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
Deciphering the SAAG - Serum to Ascites Albumin Gradient
Ascites is either made in the liver sinusoid
oncotic pressure Low ... Interpretation #Differential
Antibiotic Prophylaxis for Endoscopy (ASGE 2015) 

Give Antibiotics: 
 - PEG tube placement (or PEG-J)
- EUS-FNA of pancreatic ... Prophylaxis #Endoscopy #EGD