JAUNDICE UNIV VAN PTA Pretoria Academic Hospital GASTROENTEROLOGY

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Presentation transcript:

JAUNDICE UNIV VAN PTA Pretoria Academic Hospital GASTROENTEROLOGY Dr Obedy Mwantembe 24/11/2018

JAUNDICE Symptom 24/11/2018

Three Causes Prehepatic Hepatic Post Hepatic 24/11/2018

HISTORY Duration and onset Drug intake/history The Progression Associated Features Pruritus Colour of stool Anaemia 24/11/2018

PHYSICAL EXAMINATION Confirm Jaundice Xanthelasma Scratch Marks Masses – Liver/Spleen Gall Bladder Murphy’s Sign Courvoisier’s Law Courvoisier’s Sign 24/11/2018

LABORATORY Biochemistry SEROLOGY ALP GGT Anti smooth muscle antibodies Total IgG Anti-mitochondria antibodies Total IgM 24/11/2018

GASTROENTEROLOGIST SONAR MRCP ERCP 24/11/2018

SONAR Available Cost effective Not invasive Observer/ operator dependent 24/11/2018

SONAR Masses Fluids / Mixed fluids OBSTRUCTION Dilated Ducts 24/11/2018

MRCP 24/11/2018

ERCP Endoscopic Retrograde Cholangio-pancreatography Diagnostic Therapeutic 24/11/2018

ERCP Sphincterotomy Stone Extraction Stenting Cyst Drainage FBC/INR Obstructive jaundice Pancreatitis Cyst Drainage 24/11/2018

DRAINAGE After attempted Stenting PTC 24/11/2018

PERCUTANEOUS Percutaneous Transhepatic Cholangiography 24/11/2018

WELCOME TO THE DEPARTMENT EVERY DAY Mornings 24/11/2018

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