obstructive jaundice Flashcards
acute cholecystitis - presentation
fever
murphy’s sign
raised WCC
acute cholecystitis - treatment
initially:
analgesia + IV fluids
IV abx eg cefuroxime + metronidazole
cholecystectomy in 1 week
what sort of bacteria is metronidazole used for?
anaerobic
biliary colic - presentation
severe band-like upper abdominal pain ± vomiting may radiate to scapula post fatty food no fever or raised WCC murphy's sign negative
obstructive jaundice - symptoms
pale stools
dark urine
pruritus
obstructive jaundice - causes
gallstones in common bile duct - biliary colic with jaundice
carcinoma of head of pancreas
primary biliary cholangitis
primary sclerosing cholangitis
charcot’s triad
fever with rigors
jaundice
RUQ pain
ascending cholangitis
primary biliary cholangitis - presentation
pruritus - intermittent, long history
enlarged, firm liver
obstructive LFTs
what is courvoisier’s law?
weight loss + jaundice with a palpable gallbladder - means jaundice is not due to stones
mercedes-benz scar - significance
liver transplant
gallstones - role of USS and MRCP
USS - shows stones in GB but not in ducts
MRCP - shows stones in GB + ducts
gallstone pathway - what happens if USS GB confirms stones after biliary colic, acute cholecystitis or obstructive jaundice?
no suspicion of CBD stones - lap chole
suspect stones in CBD - MRCP
no stones in CBD - lap chole
stones in CBD - ERCP, sphincterectomy + dorm basket extraction. post this:
success - lap chole
failure - lap or open chole + explore CBD + T tube
