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Clinical Challenges and Complications of IBD
1 related chapter
Chapter 10: Hepatobiliary Disease
Clinical Nutrition in Gastrointestinal Disease
4 related chapters
Chapter 13: Metabolic Bone Disease In Gastrointestinal Illness
Chapter 21: Nutrition In Chronic Pancreatitis
Chapter 22: Nutritional Support In Acute Pancreatitis
Chapter 28: Clinical Implications Of Oxidative Stress And Antioxidant Therapy In Gastrointestinal Disease
Common Liver Diseases and Transplantation: An Algorithmic Approach to Work Up and Management
1 related chapter
Chapter 9: Autoimmune And Cholestatic Diseases
Complicated Cases in GI
6 related chapters
Chapter 14: A Surprising Cause Forbleeding Gastric Varices
Chapter 35: An Unusual Cause Ofre Current Acute Pancreatitis
Chapter 36: A 74-Year-Old Man with Refractory Diarrhea
Chapter 37: Diarrhea, Abdominal Pain, And A Dilated Biliary Tree
Chapter 38: Biliary Drainage Through The Minor Papilla
Chapter 58: An Unusual Cause of Acute Recurrent Pancreatitis
Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition
22 related chapters
Question 12: A 38-Year-Old Mildly Obese Female Presented With Gerd Symptoms And Was Found To Have A Persistently Elevated Amylase Level Around 250 Iu/L (Normal < 125) But Normal Lipase. How Should I Manage This Patient?
Question 23: A 55-Year-Old Veteran Had A Ruptured Gallbladder And A Difficult Cholecystectomy. Postoperatively, The Patient Had Persistent Bile Leakage Despite Months Of Multiple Biliary Stenting. What Can I Do?
Question 24: A 65-Year-Old Male On Plavix Following A Recent Mi And Coronary Stenting Was Seen In The Er With Fever, Pain, Jaundice, And A Wbc Of 18,000. Us Showed A Dilated Bile Duct Of 15 Mm And A Gallbladder Full Of Stones. Mrcp Revealed A 15-Mm Stone In The Distal Cbd. What Would You Do?
Question 25: What Is The Best Endoscopic Method To Diagnose Pancreatic Cancer? What Is The Best Way To Sample Tissue To Diagnose Suspected Bile Duct Cancer?
Question 26: A 68-Year-Old Man With A Klatskin’S Tumor Was Referred For Consideration Of Ercp And Palliative Drainage. How Should I Manage The Patient?
Question 27: An Elderly Patient With Multiple Medical Problems Presents With Acute Pancreatitis And Stones In The Gallbladder. Lfts Show Ast Of 90 And Alt Of 95, Both Declining. Mrcp Shows No Cbd Stones Or Ductal Dilation. Is Ercp Indicated?
Question 28: I Have A Patient With Biliary-Type Pain, But No Other Evidence Of Bile Duct Disease (Normal Diameter Duct On Ultrasound, Normal Liver Function Tests). How Should Such A Patient Be Managed?
Question 29: How Can We Accurately Determine The Appropriate Length Of The Stent To Use In A Patient With A Bile Duct Stricture?
Question 30: A 56-Year-Old Female Presents With Recurrent Ruq Pain, Impaired Lfts, Elevated Alkp, And Transaminases. She Had A Prior Ercp And Possible Biliary Papillotomy For Similar Complaints But She Does Not Recall The Diagnosis. What Should I Do?
Question 31: My Accountant, Whose Ulcerative Colitis Is In Good Control On Maintenance 5 Asa Therapy, Called Because His Lfts Were Elevated. He Had No History Of Jaundice, But New Onset Of Itching. What Should I Do?
Question 32: My 35-Year-Old Patient Who Had A Cholecystectomy 5 Years Ago During Her Gastric Bypass Surgery Presents With Abdominal Pain And Impaired Lfts. Ct Showed A 15-Mm Cbd With A Distal Cbd Stone. Ercp Was Unsuccessful Using A Pediatric Scope. Can You Help?
Question 33: A 48-Year-Old Male Had Liver Transplantation 9 Months Ago For Chronic Hep C Cirrhosis. He Presented Recently With Recurrence Of Jaundice And Impaired Lfts. How Should I Manage This Patient?
Question 34: A 68-Year-Old Banker Who Had A Prior Whipple For Periampullary Cancer Had Recurrent Abdominal Pain And Fever For 3 Years. Each Resolved With Antibiotics. Lfts Are Impaired And Ct Scan Shows Dilated Intrahepatic Ducts And A Tubular Structure In The Pancreas. What Should I Do?
Question 35: A 78-Year-Old Vietnamese Woman Who Collapsed At Home Was Found To Be Febrile And In Shock With A Systolic Bp Of 80 Mm Hg. She Is Mildly Jaundiced With Abdominal Guarding. How Would You Manage Her?
Question 36: My 68-Year-Old Patient With Ms Presents With Dyspeptic Symptoms And Loose Stools. Imaging Showed A Dilated Pancreatic Duct And Extensive Calcification In The Head Of The Pancreas. Symptoms Responded Partly To Pancreatic Enzyme Supplement. What Should I Do Next?
Question 37: A 12-Year-Old Patient Has A 5-Year History Of Recurrent “Acute Pancreatitis,” Managed Conservatively With Pancreatic Enzymes Supplement. Ct Reveals Mildly Dilated Pancreatic Duct With A Possible Stone In The Head Of The Pancreas. What Else Can I Do?
Question 38: A 25-Year-Old Female Presents With Recurrent Abdominal Pain And Mildly Elevated Serum Amylase And Lipase Levels, Normal Lfts. Abdominal Imaging Shows Normal Size Cbd, Pd, And No Obvious Stones In The Gallbladder. What Should I Do Next?
Question 39: What Is The Best Treatment For Duodenal Or Ampullary Adenoma, And What Is The Current Recommendation For Surveillance After Treatment?
Question 40: What Should Be The Sequence Of Investigations For A Patient With Recurrent, Unexplained Pancreatitis?
Question 42: How Do We Manage A Patient With A 10-Cm Pseudocyst Who Is Currently Asymptomatic?
Question 43: Do All Pancreatic Cysts Need Eus Imaging, And Do They All Need To Be Aspirated For Analysis? Are There Even Standard Criteria To Determine Their Origins?
Question 44: Our Endosonographer Frequently Detects Vague Hypoechoic Pancreatic Lesions, But Does Not Perform Fine Needle Aspiration—He Recommends Follow Up Eus In 3 Months. How Many Follow Up Exams Are Needed? Are Fine Needle Aspirations Unsafe?
Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions
16 related chapters
Question 14: A 54-Year-Old Woman Has Weight Loss And Back Pain. An Ultrasound Is Suggestive Of A Solid Mass In Her Pancreas. How Should Her Evaluation Best Proceed With Regards To Diagnosis And Staging?
Question 15: Do Patients With Pancreatic Cancer And Jaundice Need To Have An Endoscopic Retrograde Cholangiopancreatography Preoperatively?
Question 16: A 43-Year-Old Woman Has Syncope Due To Hypoglycemia. An Insulinoma Is Suspected. Computed Tomography And Magnetic Resonance Imaging Of Her Abdomen Are Negative. How Should This Patient Be Further Evaluated?
Question 17: How Should A Cystic Pancreatic Lesion Be Evaluated Prior To Treatment? Which Cystic Lesions In The Pancreas Require Resection And Which Can Be Followed Conservatively?
Question 18: What Is The Role Of Metal Biliary Stents In Patients With Unresectable Pancreatic Cancer And Jaundice?
Question 19: Should Patients With A Strong Family History Of Pancreatic Cancer Be Screened For The Disease, And If So, How?
Question 20: A 78-Year-Old Woman With Pancreatic Cancer And Severe Pain Is Referred To You For Evaluation. What Is The Role Of Celiac Plexus Neurolysis To Control Pain In These Patients?
Question 21: A 70-Year-Old Man With Pancreatic And Liver Cancers Develops Gastric Outlet Obstruction Due To A Mass Compressing The Mass Proximal Duodenum. What Treatment Options Exist For This Situation?
Question 22: A 67-Year-Old Man With Pancreatic Adenocarcinoma Undergoes Endoscopic Ultrasound, Which Reveals Malignant Adenopathy And Superior Mesenteric And Portal Vein Involvement. What Treatment Options Exist For This Patient?
Question 23: A 68-Year-Old Man Develops Painless Jaundice. Endoscopic Retrograde Cholangiopancreatography Demonstrates A Large Ampullary Mass. Biopsies Demonstrate Adenocarcinoma. How Should This Patient Be Managed?
Question 24: A 24-Year-Old Woman Is Found To Have Primary Sclerosing Cholangitis. What Is Her Risk Of Developing Cholangiocarcinoma?
Question 25: What Is The Role Of Endoscopic Retrograde Cholangiopancreatography And Endoscopic Ultrasound In Patients With Suspected Cholangiocarcinoma?
Question 26: Which Patients With Cholangiocarcinoma Are Candidates For Surgical Resection? Is Liver Transplant An Option For Patients With Cholangiocarcinoma?
Question 27: What Oncologic Treatment Options Exist For Patients With Cholangiocarcinoma Who Are Not Considered Surgical Candidates?
Question 28: Should Patients With Unresectable Cholangiocarcinoma And Jaundice Be Managed Via Endoscopy With Stents, Interventional Radiologists With Drains, Or Both?
Question 29: What Is The Role Of Photodynamic Therapy And Brachytherapy In Patients With Cholangiocarcinoma?
Curbside Consultation of the Pancreas: 49 Clinical Questions
45 related chapters
Question 1: How Much Fluid Should Be Given During The Initial Management Of Acute Pancreatitis?
Question 2: Should I Check A C-Reactive Protein During All Admissions For Pancreatitis?
Question 3: When Should I Consider Performing A Computed Tomography Of The Abdomen In Patients With Acute Pancreatitis?
Question 4: When Would You Use Antibiotics In Acute Pancreatitis, And Which Antibiotics Would You Use?
Question 5: What Can Be Done To Minimize Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis?
Question 6: What Is The Best Approach To Nutrition In Acute Pancreatitis?
Question 7: When Should Gallstones Be Considered The Etiology Of Acute Pancreatitis?
Question 8: When Should An Endoscopic Retrograde Cholangiopancreatography Be Performed In Acute Gallstone Pancreatitis?
Question 9: My Patient Had A Single Episode Of Uncomplicated Gallstone Pancreatitis. Should He Have A Cholecystectomy, And, If So, When?
Question 10: Should A Cholecystectomy Be Performed On Patients With Acute Pancreatitis, No Gallstones, But Sludge In The Gallbladder?
Question 11: When Would You Perform Surgery In Acute Pancreatitis?
Question 12: What Should Be The Sequence Of Investigations For A Patient With Recurrent, Unexplained Acute Pancreatitis?
Question 13: How Is Hypertriglyceridemia Treated When Suspected In Causing Acute Pancreatitis?
Question 14: My Patient With Crohn’S Disease Developed Pancreatitis On Imuran. Can He Take 6-Mp?
Question 15: My Patient With Acute Pancreatitis Has A Computed Tomography Scan With Thrombosis Of The Splenic Vein. Is It Safe To Anticoagulate Him?
Question 16: How Is The Diagnosis Of Chronic Pancreatitis Established?
Question 17: What Is The Best Method Of Treating Pain In Patients With Chronic Pancreatitis?
Question 18: Is There A Role Of Pancreatic Enzymes To Treat Pain In Patients With Chronic Pancreatitis?
Question 19: What Is The Pathophysiology Of Alcohol-Induced Injury To The Pancreas?
Question 20: When Should One Suspect Autoimmune Pancreatitis As A Cause Of Acute Or Chronic Pancreatitis?
Question 21: What Are The Complications Of Chronic Pancreatitis?
Question 22: My Patient Is A Middle-Aged Woman With An Asymptomatic 5-Cm Fluid-Filled Cyst In The Tail Of The Pancreas, Found Incidentally On Abdominal Computed Tomography Scanning. What To Do Next?
Question 23: What Is The Best Approach To A Cystic Lesion In The Tail Vs Head Of The Pancreas When The Diagnosis Cannot Be Clearly Established?
Question 24: Endoscopic Ultrasound-Guided Fine Needle Aspiration Of A Pancreatic Cyst In This Patient Yielded Fluid With An Amylase Of 4500 And A Carcinoembryonic Antigen Of 20. Is This Normal?
Question 25: Why Is It Important To Distinguish Serous Cystadenoma And Mucinous Cystadenoma?
Question 26: My Hospital Does Not Have An Endoscopic Ultrasonographer. Is It Safe For Me To Use Computed Tomography-Guided Fine Needle Aspiration For A Pancreatic Lesion?
Question 27: How Does One Manage Pseudocysts?
Question 28: How Do I Determine When A Pseudocyst Has Become Infected? How Do I Manage This?
Question 29: My Patient Has A Large Pancreatic Cyst. Should I Involve A Surgeon In The Evaluation And Management Of This Situation?
Question 30: When Should Endoscopic Therapy Of The Pseudocyst And/Or Organized Necrosis In Acute Pancreatitis Be Applied?
Question 31: What Are The Risk Factors For The Development Of Pancreatic Cancer?
Question 32: What Is The Best Approach To Staging Pancreatic Cancer?
Question 33: What Are The Treatment Options For Early And Locally Advanced Pancreatic Cancer?
Question 34: In A Patient With Recurrent Hypoglycemia, How Does One Evaluate For An Insulinoma?
Question 35: My Patient Has Chronic Diarrhea And Extensive Work-Up Has Been Negative. How To Establish A Diagnosis In A Patient Suspected Of Having Vipoma?
Question 37: What Masses Mimic Pancreatic Cancer?
Question 38: What Is The Role Of Cholangiopancreatoscopy In Pancreaticobiliary Disease?
Question 39: My Patient Had A Magnetic Resonance Cholangiopancreatography To Evaluate For Common Bile Duct Stones, But The Reading Includes A “Double Duct Sign.” What Does This Mean? Does It Need Endoscopic Retrograde Cholangiopancreatography?
Question 40: How Should I Discuss The Risks Of Post-Procedure Pancreatitis With A Patient Whom I Am Consenting For Endoscopic Retrograde Cholangiopancreatography? Do I Really Have To Tell Him He Could Die?
Question 41: In A Patient With Gallstone Pancreatitis, When Should An Endoscopic Retrograde Cholangiopancreatography And/Or Magnetic Resonance Cholangiopancreatography Be Performed Preoperatively?
Question 44: Choledochal Cyst, What To Do? Watch, Ignore, Or Operate?
Question 45: What To Do In A Patient Suspected Of Having Cholangiocarcinoma?
Question 47: What Is The Best Approach To The Patient With Suspected Sphincter Of Oddi Dysfunction?
Question 48: When Should A Pancreatic Duct Stent Be Used?
Question 49: How Do I Evaluate For And Treat Patients With Autoimmune Pancreatitis?
GI and Liver Disease During Pregnancy: A Practical Approach
2 related chapters
Chapter 9: Surgical Management Of The Pregnant Patient
Chapter 10: Pancreatitis And Biliary Issues