A young male with Cholangitis
A make aged 42 years p/w Chief Complaints Jaundice (Progressive) Pain RUQ Fever (on/off) (x 20 days) Physical Examination Hepatomegaly(+) Icterus(+) Investigations MRCP
Obstructive jaundice. Consider stenting or surgical intervention
Gallbladder is dialated Big calculus seen in CBD Cholangitis + Adv cholecystectomy
Its a case of Obstructive jaundice
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Friends, I am presenting a very important case scenario for discussion. Let's go step by step: 35 years old lady, no comorbidities, good performance status, presented with obstructive jaundice for 1 month. Apart from icterus rest of the examination was normal. At presentation, s. Bill 10, ALP 300. MRCP and CECT films are presented. How to proceed further? If want further relevant investigation I'll provide.
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A 45 yr old lady, presented with history of pain abdomen for 4 weeks and jaundice for 5 days. USG revealed gallstones and a dilated CBD. Bilirubin was 5mg%, and SGOT/SGPT 102/88. Alkaline phosphatase was 481. The patient underwent MRCP, which also revealed dilated CBD till lower end, however, no CBD stone could be seen. What could be the diagnosis? How to proceed with the case?
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28yr/M, k/c/o Cholelethiasis, presented with Pain Abdomen, Pain Chest, SOB. He is non DM, non Hypertensive, Serum Amylase, Lipase within Normal limits. He is having 'Jaundice'.
Dr. Kunal Datta8 Likes25 Answers - Login to View the image
52/female brought to casualty in drowsy state with c/o progressively increasing jaundice since 2 months for which they were taking some ayurvedic medicines from a quack. pt is non alcoholic, no h/o blood transfusion, fever, no h/o significant weight loss. o/e- drowsy, pulse- 110/min, BP- 90/60. spo2 98% on air. icterus, pallor and pedal edema present. P/A- liver palpable 4 cms and free fluid present. within 1 hour of admission she started with profuse malena and hematemesis. Ix showed Hb (6.8), TLC (10,300), Plt (4.17L), Total Bil (18), direct (10) indirect (8), OT/PT (265/121), Albumin (3.5),Globulin (3.1), serum ammonia 250, HBSAg, HCV negative, INR (1.8), Urea (46), creat (1.9), Na (145), K (2.9). Diagnostic Ascitic tap was done and report attached (ADA and cytology awaited). USG and CT abdomen attached. could it be malignancy? can obstructive jaundice present directly at this terminal stage? patient had no h/o abdominal pains before and had no h/o gall stones. Budd Chiari?
Dr. Naved Memon6 Likes16 Answers - Login to View the image
Plain X-ray Abdomen taken before scheduling for Lap cholecystectomy. What is clinical scenario
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