SURGICAL JAUNDICE

Posted by e-Medical PPT Tuesday, August 10, 2010
Aetiology of obstructive jaundice
* Common
* Infrequent
  • Ampullary carcinoma
  • Pancreatitis
  • Liver secondaries
* Rare
  • Benign strictures - iatrogenic, trauma
  • Recurrent cholangitis
  • Mirrizi's syndrome
  • Sclerosing cholangitis
  • Cholangiocarcinoma
  • Biliary atresia
  • Choledochal cysts

Complications of obstructive jaundice
* Ascending cholangitis
  • Charcot's triad is classical clinical picture
  • Intermittent pain, jaundice and fever
  • Cholangitis can lead to hepatic abscesses
  • Need parenteral antibiotics and biliary decompression
* Clotting disorders
* Hepato-renal syndrome
  • Due to gram negative endotoxinaemia from gut
  • Preoperative lactulose may improve outcome
  • Improves altered systemic and renal haemodynamics
* Drug Metabolism
  • Half life of some drugs prolonged. (e.g. morphine)
* Impaired wound healing

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