Concluded Case

Cholelithiasis with viral hepatitis?

A 39 years old female with jaundice with s.Bilirubin - 4.2 mg /dl and pain upper abdomen. Ultrasonography abdomen is indicative of Cholelithiasis and normal CBD . As per the reports- it doesn't look like obstructive jaundice. It looks like a case of Cholelithiasis with concomitant viral hepatitis. Opinion welcomed

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Intresting case with multiple problems Nonobstructive jaundice But GB has multiple calculi one is quite big but small one at neck of G B and there is sludge LFTS do suggest viral hepatitis Splenomegaly what is explanation She has multiple fibroids and bartholin cyst Need to workout for viral aetiology Treatment for same once pt recovers will need surgical intervention cholecystectomy as well as hystrectomy But for splenomegaly my suggestion to work on enteric or malarial aetiology

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What is the duration of jaundice and pain abdomen? Is there any associated fatigue, pruritus, nausea? The LFT is s/o cholestatic hepatitis and less likely obstructive jaundice. Viral hepatitis are known to be associated with cholestatic hepatitis. Other causes are DILI, AIH overlap. So, rule out viral etiology first followed by monitoring of LFT and workup accordingly for other causes.

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Intresting case with multiple problems Nonobstructive jaundice But GB has multiple calculi one is quite big but small one at neck of G B and there is sludge LFTS do suggest viral hepatitis Splenomegaly what is explanation She has multiple fibroids and bartholin cyst Need to workout for viral aetiology Treatment for same once pt recovers will need surgical intervention cholecystectomy as well as hystrectomy But for splenomegaly my suggestion to work on enteric or malarial aetiology

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USG have calculous cholecystitis with a large stone , small stone with sludge and one at the neck, fatty liver and multiple fibroids uterus LFT having suggestive viral hepatitis as liver enzymes are deranged but striking point is rise of serum alkaline phosphatase suggestive of obstructive jaundice but no suggestive finding in USG so think may be due to oedema of the biliary tree due to viral infection causing obstruction of biliary passage and leading to rise of serum alkaline phosphatase and to treat the pt in the line of viral hepatitis Later can be planned for cholecystectomy.

आयुर्वेद के अनुसार रोगी भ्रष्ण कामला से पीड़ित है। चिकित्सा संबंधी योग,,,,, यकृत दारी लौह 4 रत्ती ताप्तयादि लौह 4 रत्ती शहद में मिलाकर सुबह-शाम सेवन कराएं। ताजा गिलोय का काढ़ा बनाकर पीने को दें। गाय का मूत्र 50 ग्राम सुबह को दें। कुमारियासव द्राक्षासव दोनों को मिलाकर 25 ग्राम सुबह-शाम खाने से पहले दें। रोगी को यवागु एवं विलेपी पर रक्खे एक सप्ताह तक।

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