obstructive jaundice Flashcards
what tests should you order for someone with suspected jaundice
Serum amylase
Prothrombin time
what are the most appropriate radiological investigations
US scan first
If answer is unclear - MRCP scan
if both fail to reveal cause - CT scan to exclude other causes
Imaging subsequently confirmed common bile duct gallstones. What treatment options should be discussed to relieve his jaundice?
If patient remains well, his jaundice fails to spontaneously resolve, there is a confirmation of galbladder stones and CBD stones - laparoscopic cholecystectomy and simultaneously CBD exploration
ERCP then laparoscopic cholecystectomy after discharge when the patient has recovered
Removal of CBD stones endoscopically - laparoscopic/open cholecystectomy with CBD exploration
open surgery
what is obstructive jaundice
Obstructive jaundice is a specific type of jaundice, where symptoms develop due to a narrowed or blocked bile duct or pancreatic duct, preventing the normal drainage of bile from the bloodstream into the intestines
what are some causes of jaundice (pre/intra/post)
prehepatic jaundice - increased production of BR
intrahepatic jaundice - decreased uptake of BR, decreased conjugation, decreased
secretion, decreased outflow - cholestasis
posthepatic jaundice - decreased extrahepatic flow
what is endoscopic retrograde cholangiopancreatography (ERCP)
wire inserted from the bottom and take out gallstones using telescope
what is percutaneous transhepatic cholangiography (PTC)
a procedure to allow doctors to insert a stent through the skin and liver into the top of the bile duct
