medical notes

Apr 17th, 2015
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OBSTRUCTIVE JAUNDICE/ SURGICAL JAUNDICEDefinitionJaundice amenable to surgical treatment -usually due to extra hepatic obstruction in the flow of bile.Common causes include:1.Cholelithiasis/choledocholithiasis2.Pancraestic head carcinoma3.Common bile duct strictures mostly iatrogenic-ERCP and cholecytectomy.4.Cholangiocarcinoma5.Choledochocele ,Choledochal cysts and congenital atresia6.Infections - Parasitic-Clonorchis sinesnsis and Ascaris Lumbricoides - Opportunistic infections in HIV-Cryptosporidium, CMV, Microsporidia, TB adenitis7.Other Tumours- Hepatoma, lymphomas, stomach cancer ,Colorectal cancer, Ampullary cancer of Duodenum, Gallbladder Adenocarcinoma8. Pancreatic pseudo- cystsCHOLELITHIASIS-Cholelithiasis is the presence of gallstones in the gallbladder. The spectrum of gallbladder disease in cholelithiasis ranges: 1) Asymptomatic gallstones-Up to 90%2) gallbladder colic/biliary colic.3) Cholecystitis4) Choledocholithiasis5) Cholangitis-Gallbladder colic is pain caused by a stone temporarily obstructing the cystic duct or common bile duct (CBD)-Cholecystitis is inflammation of the gallbladder from obstruction of the cystic duct or CBD (choledocholithiasis or common bile duct stone)-Cholangitis is infection of the biliary tree. Pathophysiology: Three types of gallstones exist. (1) Cholesterol (most common)(2) Pigment-calcium bilirubinate-15%(3) Mixed stones-Impaired gallbladder motility, bile stasis and bile content alt

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