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JAUNDICE

JAUNDICE . UNIV VAN PTA Pretoria Academic Hospital GASTROENTEROLOGY Dr Obedy Mwantembe. JAUNDICE. Symptom. Three Causes. Prehepatic Hepatic Post Hepatic. HISTORY. Duration and onset Drug intake/history The Progression Associated Features Pruritus Colour of stool Anaemia.

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JAUNDICE

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  1. JAUNDICE UNIV VAN PTA Pretoria Academic Hospital GASTROENTEROLOGY Dr Obedy Mwantembe

  2. JAUNDICE • Symptom

  3. Three Causes • Prehepatic • Hepatic • Post Hepatic

  4. HISTORY • Duration and onset • Drug intake/history • The Progression • Associated Features • Pruritus • Colour of stool • Anaemia

  5. PHYSICAL EXAMINATION • Confirm Jaundice • Xanthelasma • Scratch Marks • Masses – Liver/Spleen • Gall Bladder • Murphy’s Sign • Courvoisier’s Law • Courvoisier’s Sign

  6. LABORATORY • Biochemistry • ALP • GGT • SEROLOGY • Anti smooth muscle antibodies • Total IgG • Anti-mitochondria antibodies • Total IgM

  7. GASTROENTEROLOGIST • SONAR • MRCP • ERCP

  8. SONAR • Available • Cost effective • Not invasive • Observer/ operator dependent

  9. SONAR • Masses • Fluids / Mixed fluids • OBSTRUCTION • Dilated Ducts

  10. MRCP

  11. ERCP • Endoscopic Retrograde Cholangio-pancreatography • Diagnostic • Therapeutic

  12. ERCP • Sphincterotomy • FBC/INR • Stone Extraction • Stenting • Obstructive jaundice • Pancreatitis • Cyst Drainage

  13. DRAINAGE • After attempted Stenting • PTC

  14. PERCUTANEOUS • Percutaneous Transhepatic Cholangiography

  15. WELCOME TO THE DEPARTMENT • EVERY DAY • Mornings

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