⏱️Less than 3 months to go until the BSPGHAN trainees meeting! . 📚Book your place now to avoid being disappointed: 👩‍⚕️Our programme caters for paeds trainees with interest in gastroenterology, current grid trainees and those exploring a career in PGHAN.

Calling all future paediatric gastroenterologists! 📢. Sign up now for the 2025 BSPGHAN trainees meeting: ✅ Expert talks from leading gastroenterologists. ✅ Meet like-minded trainees and share learning. ✅ Interactive sessions and case discussions.

📢 Guts UK/BSPGHAN Grants 📢. Two development grants of up to £40,000 for research on paediatric gastrointestinal, hepatological and nutritional disorders are now open 🎉 Max duration 24 months. Applications close 30/06/25 at 5pm!. Visit: @GutsCharityUK.

Check out the latest episode of the pIBD Digest podcast: . From food to FMT: Microbiome based treatments in IBD with guest Dr Richard Hansen. Spotify: Apple Podcasts: @PaedsRH @tracycoelhoUHS @CICRAcharity.

RT @FrontGastro_BMJ: Great #FGPodcast with @GiamourisV and Dr Tassos Grammatikopoulos from @KingsCollegeNHS being interviewed by @OTavabie….

RT @tracycoelhoUHS: 'THE pIBD DIGEST ' is an educational podcast exploring paediatric inflammatory bowel disease (….

Looking forward to #BSPGHAN2024 in Bristol tomorrow! . Check out the excellent programme here:.

Telangiectasia changes may be more difficult to treat as you cannot band or use sclerotherapy for it. #BSPGHANTM.

Features of severe OVs include:. Different varices touching/meeting.Degree OV takes up lumen.Tortuosity.Red spots (the point of bleeding)/Wales (little veins on top of the varix). These make the varix clinically significant and need treatment. #BSPGHANTM.

Measurement of varices is influenced by air insufflation, breathing pattern, and peristalsis. #BSPGHANTM.

There are various historical endoscopic classifications of varices - Cales, Japanese Research Society for PHT, and American Assoc. for study of liver disease. These classifications are not consistent with each other. #BSPGHANTM.

When we scope these patients it's important to answer two major questions:.1. Are there varices?.2. If yes, are they severe enough to manage medically or endoscopically?. Treatment mode and freq. of scope is decided by varices status. #BSPGHANTM.

Decompensation of liver disease often shows drops in sodium, albumin, raising bili and INR every time a patient has a bleed. #BSPGHANTM.

Diagnosis of PHT:.1. Often presentation is splenomegaly - do a US abdo to look at the PV and echogenicity of the liver.2. Bloods: low platelets or pancytopenia (hypersplenism).3. Ascites.4. GI endoscopy - upper and lower.5. Radiology - US, CT, MRV. Maybe angio.#BSPGHANTM.

PHT is increased BP within the portal venous system (normal is 5-10mmHg). Presinusoidal - extrahepatic (PV thrombus), intrahepatic (CHF, schisto).Sinusoidal (cirrhosis).Post-sinusoidal - hepatic vein occlusion - Budd-Chiari syndrome, Rt heart failure. #BSPGHANTM.

Our next speaker is Dr Tassos Grammatikopoulos - Consultant Hepatologist of King's College Hospital London, teaching us about portal hypertension in childen; variceal classification and diagnosis. #BSPGHANTM.

Clinicopathological correlation is key.Clinical history on forms is important.Submit separate biopsies of key different areas or state locations if sending a series.Discuss early if considering rare diagnoses.Remember path can review old biopsies - just ask!. #BSPGHANTM.

Enzyme analysis eg disaccharide deficiencies - tissue needs freezing within 1hr. It's not possible to perform some histochem stains on formalin specimens. Electon microscopy fixative needs to be used when querying microvillus inclusion disease. #BSPGHANTM.

When should we send fresh biopsies?. Talk to the pathologist first - what sites/number of biopsies/where to send may change. Important when querying congenital enteropathies and some metabolic disorders. #BSPGHANTM.

When presented with resection material, histopathologists will use clinical acumen to decide where to section to find a representative segment of gut. #BSPGHANTM.