The Specialty certificate in Gastroenterology SCE covers the whole of the curriculum of the specialty training in gastroenterology in the UK. Preparation for this exam requires a wide breadth of knowledge around the curriculum . As knowledge is constantly advancing , awareness of current and updated guidelines is important.This blog is an attempt to pool all resources in one site with regular updates.
Dr Elmuhtady Said
Curriculum for Specialty Certificate Examination in Gastroenterology
Nonobstructive saccular or fusiform dilation of the intrahepatic bile ducts is a rare congenital disorder. In the pure form, known as Caroli disease, dilation is classically segmental and saccular and associated with stone formation and recurrent bacterial cholangitis. A more common type, Caroli syndrome, is associated with a portal tract lesion typical of congenital hepatic fibrosis. Dilation of the extrahepatic bile ducts (choledochal cysts) also may be present. Renal disease occurs in both forms. Renal tubular ectasia occurs with the simple form, and both conditions can be associated with autosomal recessive polycystic renal disease or, rarely, autosomal dominant polycystic renal disease. There may be slight to moderate elevations of serum bilirubin, alkaline phosphatase, and aminotransferase levels. Liver function may be normal initially, but repeated episodes of infection and biliary obstruction within the cystic bile ducts may eventually lead to hepatic failure. Inability to concentrate urine is the most frequent abnormality of renal function; variable elevations of blood urea nitrogen and serum creatinine levels reflect the severity of the underlying kidney disease. Ultrasonography, MRI cholangiography, and CT are of great value in demonstrating intrahepatic cystic dilation. Renal cysts or hyperechogenicity of papillae may be detected. Cholangiography usually demonstrates a normal common duct with segmental, saccular dilations of the intrahepatic bile ducts. Rarely, the process may be limited to one lobe of the liver.
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the liver already present. I started on antiviral medications which reduced the viral load initially. After a couple of years the virus became resistant. I started on HEPATITIS B Herbal treatment from ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their treatment totally reversed the virus. I did another blood test after the 6 months long treatment and tested negative to the virus. Amazing treatment! This treatment is a breakthrough for all HBV carriers.
Nonobstructive saccular or fusiform dilation of the intrahepatic bile ducts is a rare congenital disorder. In the pure form, known as Caroli disease, dilation is classically segmental and saccular and associated with stone formation and recurrent bacterial cholangitis. A more common type, Caroli syndrome, is associated with a portal tract lesion typical of congenital hepatic fibrosis. Dilation of the extrahepatic bile ducts (choledochal cysts) also may be present. Renal disease occurs in both forms. Renal tubular ectasia occurs with the simple form, and both conditions can be associated with autosomal recessive polycystic renal disease or, rarely, autosomal dominant polycystic renal disease. There may be slight to moderate elevations of serum bilirubin, alkaline phosphatase, and aminotransferase levels. Liver function may be normal initially, but repeated episodes of infection and biliary obstruction within the cystic bile ducts may eventually lead to hepatic failure. Inability to concentrate urine is the most frequent abnormality of renal function; variable elevations of blood urea nitrogen and serum creatinine levels reflect the severity of the underlying kidney disease. Ultrasonography, MRI cholangiography, and CT are of great value in demonstrating intrahepatic cystic dilation. Renal cysts or hyperechogenicity of papillae may be detected. Cholangiography usually demonstrates a normal common duct with segmental, saccular dilations of the intrahepatic bile ducts. Rarely, the process may be limited to one lobe of the liver.
ReplyDeleteI was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.