A male with Obstructive Jaundice

A male aged 48 years Chief Complaints Gradually increasing Jaundice Pruritus and Acholic Stools Pain Abdomen radiating to back (x 20 days) Physical Examination Icterus(++) No lump palpable

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Big Gall bladder calculus seen in mid of CBD Hepatic resurgence noted Gall bladder is collapsed Pt is alcoholic Obstructive jaundice D/d pancreatitis Rx stenting of CBD Cholecystectomy

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NEEDS ULTRASOUND ABDOMEN L F T URINE ANALYSIS FOR URIBILINOGEN DD GALL BLADDER STONES MOST IMPORTANT STONE IN C B D E R C P PANCREATITIS HEAMOCHROMOCYTOSIS S C DESEASE

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Gall stone Do lft Conjugate bilirubin alkaline phosphates raised in Obstructive jaundice Frcp ldh serum amylase

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Advise-1-LFT. 2-usg of whole abdomen. Endoscopic or laproscopic removal of gall stone and common bile duct stone. Thereafter hepatoprotective therpy for liver.

Dx-obstrutive jaundice due to common bile duct and gall bladder stone.
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Clear cut in mrcp film that patient is suffering from CBD stones. Plan ercp for stone removal if stone is not removed with ercp then plan laparoscopic exploration of CBD and stone removal along with gb removal

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