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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Screening and surveillance of varices in patients with cirrhosis. 

- No for screening need if platelets
surveillance of varices ... -2/fulltext #varices ... #Variceal #Screening ... #Surveillance #Hepatology ... #EGD #PrimaryCare
Variceal Screening Algorithm in Cirrhosis
No varices -> repeat 2-3 years 
Small varices->repeat 1-2 years unless child
Variceal Screening ... Cirrhosis No varices ... years Small varices ... Screening #Algorithm #EGD ... #varices #hepatology
Endoscopic Bleeding Risk - Summary points from ASGE guideline 

Low Risk Procedures 
 - Diagnostic endoscopy
Procedures - Diagnostic ... forceps biopsy (EGD ... Polypectomy - Variceal ... Gastroenterology #EGD ... #Management #Guidelines
Cirrhosis Timeline and Mortality Rate
Compensated Cirrhosis
Stage 1 - No varices (Annual Mortality Rate 1%)
Stage 2 -
Stage 1 - No varices ... 1%) Stage 2 - Varices ... Mortality #Timeline #diagnosis ... #hepatology
Endoscopy - Management of Bleeding Esophageal Varices 
What to Band?
 - Always find the varix that
Endoscopy - Management ... - Varices in ... EGD and the Banding ... #Tricks #management ... fellows #endoscopy #egd
Approach to the Diagnosis and Treatment of Spontaneous Bacterial Peritonitis. This algorithm provides a general approach
Approach to the Diagnosis ... approach to the diagnosis ... and management ... #Diagnosis #Management ... #Hepatology #SBP
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 ... #Algorithm #hepatology
Acute Esophageal Necrosis
History: Hematemesis and/or melena (70%), Dysphagia, Epigastric/chest pain, Sepsis
Diagnosis EGD and Biopsy
Differential: Melanosis, Melanoma,
chest pain, Sepsis Diagnosis ... EGD and Biopsy ... Klebsiella, pneumoniae) Management ... black #esophagus #diagnosis ... #management #gastroenterology
Spontaneous Bacterial Peritonitis (SBP) - Diagnosis and Management
Ascites PMN > 250/mm3
? Nosocomial or hospital acquired. Recent
Peritonitis (SBP) - Diagnosis ... and Management ... SBP: Medical Management ... Peritonitis #SBP #Diagnosis ... #Management #hepatology
Eosinophilic Gastroenteritis: Treatment Options Based on Severity of the Disease
Mild:
 • Trial of PPI
 • Trial
Concern for HES: • Hematology ... • Additional diagnostic ... Gastroenteritis #Treatment #management