Ibdlive

#ibdlive national video teleconference with CCF UPMC UMD. advancing the management of complex IBD care

[Ibdlive @ibdlive]

@kokellyj @SPerksGillespie @MikeKurliand @AveraHealth @Lacktman @IsraniJuhi @AlexandreaCron1 @WestHealth @AmericanTelemed Looks like an excellent panel.

Thank you all for supporting this.

#ata19
#telehealthfirst

[Ryan K. Louie, MD, PhD @ryanlouie]

.@EHealthLaw, Chair of @ClearHealthQI Standards Committee, Vice President @AmericanTelemed, Partner @JonesDay. Presenting on the Leadership Perspective. #ATA19 @NewOrleansENMCC

[Ibdlive @ibdlive]

Ah yes the classic discussion @MRegueiroMD vs @arwmd !

[Taha Qazi @tqaziMD]

@ibdlive monosyllabic vs polysyllabic discussions on a great case of poorly controlled, penetrating Crohn’s. Surgery clearly the answer, but how doe we foster the best relationships with our patients?

[Stefan Holubar MD MS @HolubarStefan]

@IBDLive Interesting article "Rescue Diverting Loop Ileostomy: An Alternative to Emergent Colect..." @arwmd @MRegueiroMD @BinionMd #IBD #IBDSurgery

[Ibdlive @ibdlive]

Case 2. IPAA. DLI. Takedown reveals a leak at J pouch

Recurrent pancreatitis. ? Pancreatic duct strictures.

#ibdlive

[Taha Qazi @tqaziMD]

@ibdlive Case #2: presenter by Dr Alka Young woman with UC, developed recurrent pancreatitis. Time to brush up On GELs and LSPS. Type 1 vs Type 2 pancreatitis. Also with a CBD stricture and PD abnormalities

[Ibdlive @ibdlive]

. #ibdlive.

[Taha Qazi @tqaziMD]

@ibdlive Case #2: presenter by Dr Alka Young woman with UC, developed recurrent pancreatitis. Time to brush up On GELs and LSPS. Type 1 vs Type 2 pancreatitis. Also with a CBD stricture and PD abnormalities

[Ibdlive @ibdlive]

Case 2. 11yo distal colitis. 2017 pancreatitis. Aug 2017 colectomy. Presents early 2018 with CBD stricture / jaundice. ERCP stent.

R/o PSC. MRCP

#ibdlive

[Ibdlive @ibdlive]

Case 1. @YaleMed

Surgery. RHV, possible extended right depending on path.

Take the mesentery with a high location.

#ibdlive

[Ibdlive @ibdlive]

Case 1. C/S, chromo and path. Multifocal LG dysplasia. #ibdlive

@YaleMed

[Ibdlive @ibdlive]

Case 1: At our @ibdlive national teleconference.

@YaleMed 60's male, Crohn's Dz '86. Surgery 2004 ICR. Now with recurrent Dz.

MRE with recurrent long TI inflammation. C/S shows LG dys. Flat polyp, in cecum.

? plan.

@MRegueiroMD
@arwmd
@IBDJournal
@CrohnsColitisFn

[Ibdlive @ibdlive]

C2. #ibdlive

Long term. Steroid taper. Working with neurologists.

@UPMC - not all sarcoid respond to anti-TNF

@BenClickMD

Thanks @MRegueiroMD for moderating.

[Ibdlive @ibdlive]

C2. #ibdlive.

Likely neuro and intestinal sarcoidosis.

Rx steroids. Improved neuro and back to baseline.

Brain sarcoid after anti-TNF.

@Marylandibddoc - picture below
@MRegueiroMD
@arwmd

[Ibdlive @ibdlive]

. #ibdlive

[Ben Click @BenClickMD]

NUD15 mutation in Hispanic patient causing severe pancytopenia. Thinking beyond TPMT. Another phenomenal case @ibdlive

[Ibdlive @ibdlive]

C2. #ibdlive

Brain Bx done.

@YaleMed - Whipple Dz

? Diffuse granulomatous process. @CleClinicMD

Challenging conversation.

@UPMC ? Vasculitic process. Re Brian Bx - hypercellular. ? Granuloma. Maybe vasculitis.

[Ibdlive @ibdlive]

C2. #ibdlive

Back to Maryland. ? Whipple Dz.

LP - WBC 101. Whipple PCR negative.

Repeat imaging. Diffuse SB thickening. Sigmoid inflammation. Confirmed on endoscopy.

[Ibdlive @ibdlive]

C2. #ibdlive

Develops neuro Sx. Status epilepticus and other Sx. Syncope, combative.

MRI. ? Gliomatosis cerebri.

Over to group discussion.

[Ibdlive @ibdlive]

C2. @Marylandibddoc 50’s make with abd pain. Prox jejunal thickening.

Jenunal thickenkng. Path - chronic active inflammation.

Dx with Crohns.

#ibdlive

[Ibdlive @ibdlive]

C1. #ibdlive

Comments. Drug toxicity likely behind this. Non surgical.

Back to RIH for comments.

Back to @CleClinicMD And at some point surgery likely.

Lehigh - started on Vedo. Homozygous defect may be behind this with AZT Rx. Alopecia a key finding.

[Ibdlive @ibdlive]

C1. Back to Lehigh. To ICU and resuscitated. IBD mess help. Held off on BM Bx. Empirical ABx. IBD workup neg. counts normalized on steroids. #ibdlive

Recent EBV infection. Asc and cecal colitis.