Endoscopic Management of Biliary Obstruction

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on Endoscopic Management of Biliary Obstruction

Diagnostic Primary sclerosing cholangitis Indeterminate biliary strictures Sphincter of Oddi manometry Patient with contraindications to noninvasive imaging Therapeutic Common bile duct stones Benign biliary strictures Malignant biliary strictures Primary sclerosing…

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IgG4 Related Cholangitis

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on IgG4 Related Cholangitis

Fig. 5.1 Schematic representation of the current hypotheses on the aetiopathogenesis of IgG4-RD and IAC. (With thanks to WouterSmit (AMC, Amsterdam) for his contribution in illustrating this figure) Role of…

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Cholestasis in the Hospitalized Patient

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on Cholestasis in the Hospitalized Patient

Primary biliary cirrhosis (PBC) Primary sclerosing cholangitis (PSC) Autoimmune sclerosing cholangitis Granulomatous hepatitis Hepatic amyloidosis Congestive hepatopathy Hepatic sarcoidosis Systemic viral infections • Hepatitis Viruses (A, B, C, D, E) • Cytomegalovirus…

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Cholestasis Post-Liver Transplantation

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on Cholestasis Post-Liver Transplantation

Early (<6 months) Late (>6 months) Extrahepatic: Extrahepatic: Stricture—single (anastomotic, external compression) Benign stricture—single (anastomotic) Stricture—multiple (HAT/ischemic) Multiple (HAT/ischemic, rPSC) Biliary leak Stones Cholangitis  Intrahepatic: Intrahepatic: Preservation/reperfusion injury Acute cellular…

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Cholestasis Related to Systemic Disorders

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on Cholestasis Related to Systemic Disorders

Canalicular impairment Sepsis Hormone mediated cholestasis (intrahepatic cholestasis of pregnancy) Congestive hepatopathy Paraneoplastic cholestasis Systemic amyloidosis Sickle cell disease Small intrahepatic bile ducts obstruction Sarcoidosis Rheumatological diseases Cystic fibrosis Graft…

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Complications of Cholestasis

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on Complications of Cholestasis

Drug/therapy Dosage Efficacy proven in controlled trials Cholestyramine 4–16 g/day (PO) Rifampicin 300–600 mg/day (PO) adult  10 mg/kg/day (PO) child Naltrexone 25–50 mg/day (PO) Naloxone 0.2 μg/kg/min (IV) Sertraline 75–100…

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Diagnosis of Cholestasis

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on Diagnosis of Cholestasis

Anabolic steroids, estrogens Amoxicillin–clavulanic acid Azathioprine Cetirizine Chlorpromazine Cyclosporin Dapsone Diltiazem Erythromycin Fenofibrate Floxuridine Gold salts Infliximab Itraconazole Metolazone Nitrofurantoin Oral contraceptives Phenytoin Rifampicin Trimethoprim–sulfamethoxazole 5-Fluorouracil or floxuridine A history…

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Drug-Induced Cholestasis

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on Drug-Induced Cholestasis

  Cholestatic (%) Mixed (%) Hepatocellular (%) Bjornsson and Olsson [13] 26 22 52 De Valle et al. [16] 40 12 48 Andrade et al. [14] 20 22 58 Chalasani…

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Primary Biliary Cirrhosis

Mar 23, 2017 by in GASTROENTEROLOGY Comments Off on Primary Biliary Cirrhosis

  Stage 1 Stage 2 Stage 3 Stage 4 Rubin et al. [59] Portal inflammation and bile duct injury Proliferation and destruction of bile ductules Cirrhosis  Scheuer [60] Florid duct…

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