GI-Jaundice

Question 1

Hemolysis/Hematoma

Answer 1

Path: Excess bilirubin from rbc turnover

Pt: Hemolysis
Resolving hematoma

Dx: increased bilirubin , indirect (clarify)

Tx: Monitor for resolution
Diagnose hemolytic disease

Question 2

Painless Obstructive Jaundice

Answer 2

Path: Cancer and Stricture

Pt: weight loss, clay colored stools, jaundice

Dx: very high bilirubin, direct
RUQ U/S = Dilation
MRCP = Lesion
EUS (pancreas), ERCP (biliary)

Tx: Resection

Question 3

Painful Jaundice

Answer 3

Path: gallstones

Pt: RUQ Pain, Tenderness
Murphys sign
Worse on eating

Dx: RUQ U/S shows gallstones, dilated ducts
MRCP for diagnosis
ERCP for intervention

Tx: ERCP for intraop cholangiogram