ASGE Annual GI Advanced Practice Provider Course - Day Two (On-Demand)

Video Transcription

Video Summary

In this video, Dr. Martin discusses various topics related to liver and digestive diseases. He begins by addressing how to work up an elevation of isolated bilirubin while having normal transaminases. He explains that if the bilirubin is elevated and the liver enzymes are normal, it suggests that the bilirubin elevation is not coming from the liver or bile duct. He also discusses the importance of fractionating the bilirubin and checking the direct fraction to determine the source of the bilirubin elevation. Dr. Martin then moves on to discussing the safety of vaccines in patients with inflammatory bowel disease (IBD). He advises that patients on biologics should not receive live vaccines but can receive non-live vaccines, including the hepatitis B series. Next, he discusses the COVID-19 vaccines and recommends them for IBD patients, noting that high-dose steroid use may affect the antibody response. Dr. Martin also addresses the management of acute pancreatitis, particularly the duration of aggressive IV fluid resuscitation, suggesting that it generally lasts for 24 to 48 hours. He emphasizes the importance of goal-directed fluid administration based on hemodynamic and laboratory parameters. Finally, Dr. Martin and another speaker answer questions regarding liver enzyme abnormalities, the use of MRCP in pancreatitis, and the role of liver biopsy in autoimmune liver disease.

Keywords

liver diseases

digestive diseases

elevation of isolated bilirubin

vaccines in patients with inflammatory bowel disease

acute pancreatitis