A lesson in life.

Call from a colleague today…

“Keith, I’ve got a 80 year old man with jaundice and fever from a large 2cm gallstone wedged in the bile duct. He’s on anticoagulation for PE. I just have a bad feeling about him and I think he needs an ERCP today.” “Is he unwell”

Him: He’s sitting out with a NEWS score of 1 (essentially normal observations).

“If he’s not scoring, we can probably wait and do his ERCP when the anticoag has washed out. His bleeding risk is too high to take out the stone.”

He gives a reluctant OK.

Here’s a thread summarising the coeliac disease guidelines in @UEGJournal @my_ueg

journals.sagepub.com/doi/pdf/10.117…

1) What is it?

CD is a chronic, multiorgan autoimmune disease that affects the small bowel in genetically predisposed persons exposed to gluten. 2) Who should be testEd?

Coeliac disease is known as the great imitator. It can cause IBS, anaemia, diarrhoea, weight loss, infertility, osteoporosis, severe fatigue, etc etc.

I recommend reading this endocrinologist’s perspective here:
bmj.com/rapid-response…

Pathology in food - a thread inspired by this wonderful paper and the recent discussions on food and pathology on Twitter.

Credit to the GRAPE working group for the paper and all images and captions:
peerj.com/preprints/2147…

Bon appetit! Grape bunches. Staphylococcus aureus are spherical bacteria known as cocci that grow in clusters that look like grape bunches.

To celebrate the return of Hemospray, here is a summary of 3 recent Hemospray papers from the same group. Hemospray for bleeding peptic ulcer disease (PUD) in @endoscopyjrnl

📅 Jan 16-March 19
🏥 14
🤕 202

✅ Immediate haemostasis: 88%
🩸 30d Rebleeding: 17%
⚰️ 30d Mortality: 22% (32% if monotherapy)

💡 "High immediate haemostasis rates for bleeding PUD"
thieme-connect.de/products/ejour…