Jaundice

Pathophysiology ,[object Object]

Categories of Jaundice ,[object Object],[object Object],[object Object]

Obstructive Jaundice ,[object Object],[object Object],[object Object],[object Object]

Gallstones ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Symptomatic gallstones diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Risks of Surgery for large duct bile obstruction. ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pancreatic Malignancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Periampullary Tumors ,[object Object],[object Object],[object Object],[object Object],[object Object]

Biliary Tumors ,[object Object],[object Object],included in peri-ampullary tumours Distal from distal common hepatic duct, cystic duct and its confluence with the common bile duct Middle from right and left hepatic ducts, hilar confluence and proximal common hepatic ducts Proximal from minor hepatic ducts, often multicentric and usually classified with primary liver tumours Intrahepatic cholangiocarcinomas Bile duct cancers

Bile duct strictures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hepatocellular Jaundice ,[object Object],[object Object],[object Object],[object Object]

Hepatic metastases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinically metastases can be: Occult Undetectable by current imaging tests at the time of resection of the primary detected at subsequent follow-up. Asymptomatic No symptoms or jaundice, although the alkaline phosphatase or gammaglutamyl transpeptidase may be elevated. Treatable, sometimes for cure. Symptomatic Large liver , jaundice, malignant ascites. Incurable and rarely treatable.

Hepatitis ,[object Object],[object Object],[object Object],[object Object]

Liver failure ,[object Object],[object Object],[object Object],[object Object],[object Object]

Cirrhosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cirrhosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Severity Scores ,[object Object],* In the original Child-Turcotte classification, nutrition was used but this has been substituted with prothrombin activity. The bilirubin has to be adjusted for patients with primary biliary cirrhosis (A = 5-7, B = 8 –10, C = 11 or more) Advanced Minimal None Encephalpathy Refractory Controlled None Ascites < 40* 40 – 65 > 64 Prothrombin level % >6.0 4-6 <4.0 Bilirubin(mol/l) <3.0 3.0-3.5 >3.5 Albumin (g/dl) C B A Parameter

Paul Brousse Hospital classification system A = none of the criteria; B = 1 – 2 criteria; C = 3 or more criteria Number of criteria Parameter 2 Coagulation factor II and V < 40% 1 Coagulation factor II and V 40 – 60% 1 Clinical ascites 1 Encephalopathy 1 Hyperbilirubinaemia > 30mol/l 1 Albuminaemia < 3.0g/100ml

Jaundice

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Jaundice