Female with advanced Carcinoma GallBladder

70 yr old female Chief Complaints Deep Jaundice Severe Pruritis Pain Abdomen High grade Fever (x 2 weeks) History No DM/HTN/Comorbidity Vitals BP- 108/60mmHg PR- 110/min Physical Examination Icterus++/Pallor+ Tenderness (+) Epigastrium, No free fluid

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Pain abdomen and high grade fever in an elderly female with MRCP s/o a type 1 hilar block is mostly due to acute bacterial cholangitis which will require IV antibiotics and biliary drainage. If the general condition of the patient is good, then can go for ERCP with stenting or else if patient is unstable then PTBD is better. Confirmation of diagnosis with either brush cytology or EUS FNA can be done after stabilization and later can be planned for palliative metallic stenting.

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Stage 4 Adenocarcinoma of gall bladder with obstruction at porta hepatis and dilated intrahepatic biliary radicals with widespread hepatic metastasis. Only palliative chemotherapy is possible Prognosis is poor

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Advanced gallbladder cancer means the cancer has spread from where it started in the gallbladder and it can't be removed with surgery Film also ascitis also with advance gallbladder carcinoma

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Dilated intrahepatic biliary channels.. cholangiocarcinoma

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