Endoscopic Management of Pancreaticobiliary Emergencies

May 30, 2017 by in GASTROENTEROLOGY Comments Off on Endoscopic Management of Pancreaticobiliary Emergencies

Pancreatic  Gallstone pancreatitis  Infected pancreatic pseudocyst  Infected pancreatic necrosis  Occluded pancreatic stent Biliary  Acute cholangitis  Acute cholecystitis  Bile leak  Hepatic abscess Pancreas In this section, we address acute gallstone pancreatitis,…

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Hemostasis of Acute Esophageal Variceal Bleeding

May 30, 2017 by in GASTROENTEROLOGY Comments Off on Hemostasis of Acute Esophageal Variceal Bleeding

Fig. 12.1 Approach to the management of acute esophageal variceal bleeding (EBL, endoscopic band ligation; TIPS, transjugular intrahepatic portosystemic shunt) Initial Assessment and Resuscitation In patients presenting with upper gastrointestinal…

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Approach to Acute Cholangitis

May 30, 2017 by in GASTROENTEROLOGY Comments Off on Approach to Acute Cholangitis

Protective mechanism Risk factors compromising protective mechanism  Mechanical  Sphincter of Oddi Sphincterotomy, biliary stents  Tight junction Increased intrabiliary pressures Bacteriostatic  Bile flow Increased intrabiliary pressures  Bile mucus Bile stasis  Bile…

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Periprocedural Management of Antithrombotic Agents

May 30, 2017 by in GASTROENTEROLOGY Comments Off on Periprocedural Management of Antithrombotic Agents

Procedural bleeding risk Thromboembolism risk Low High Low Continue antithrombotic medications Continue antithrombotic medications High Temporarily discontinue antithrombotic medications without bridging therapy Continue antithrombotic medications or temporarily discontinue antithrombotic medication…

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Approach to Suspected Small Intestinal Bleeding

May 30, 2017 by in GASTROENTEROLOGY Comments Off on Approach to Suspected Small Intestinal Bleeding

Fig. 5.1 Algorithm for obscure gastrointestinal bleeding (Reprinted with permission) [38] Role for “Second-Look” Endoscopic Examinations Approximately 20–30 % of patients with acute GI bleeding who undergo capsule endoscopy and/or…

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Triage, Sedation and Monitoring

May 30, 2017 by in GASTROENTEROLOGY Comments Off on Triage, Sedation and Monitoring

  Minimal sedation (anxiolysis) Moderate sedation/analgesia Deep sedation/analgesia General anesthesia Responsiveness Normal response to verbal stimuli Purposeful response to verbal or tactile stimulation Purposeful response after repeated/painful stimulation No response,…

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Pediatric Endoscopic Retrograde Cholangiopancreatography

May 30, 2017 by in GASTROENTEROLOGY Comments Off on Pediatric Endoscopic Retrograde Cholangiopancreatography

Device Manufacturer Comments ERCP cannulation catheters Boston Scientific, ConMed, Mediglobe, Telemed Curved, straight, or tapered tip, 0.018–0.035 in wire Sphincterotomes Cook Medical, Mediglobe, Olympus Limited to double lumen, cannot take…

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