Obstructive jaundice surgery SlideShare

Take Home • Obstructive jaundice is a huge spectrum of differentials. • Cause directed management is the key. • Choledocholithiasis is the major entity in the surgical jaundice. • Endoscopy and gastrointestinal specialised personnel is the cornerstone in management. • Narrow window of surgery in the management. 38 OBJECTIVES• clinical presentation of surgical Jaundice• Review the Causes of Jaundice• Pathophysiology of obstructive jaundice• Important Investigations• Management 3. Case Scenario• 82 yr old male patient presents withprogressive jaundice, itching, loss of weight . 4 1. OBSTRUCTIVE JAUNDICE Dr.B.Selvaraj MS;Mch;FICS; Professor Of Surgery Melaka Manipal Medical college Melaka 75150 Malaysia BILIARY ATRESIA. 2. BILIARY ATRESIA- Objectives To be aware of possible causes of surgical jaundice in infancy To be aware of clinical features of biliary atresia To be familiar with the methods of investigation To. • Biliary obstruction associated with pancreatitis is observed most commonly in patients with dilated pancreatic ducts due to either inflammation with fibrosis of the pancreas or a pseudocyst. • Notably, intravenous feedings predispose patients to bile stasis and a clinical picture of obstructive jaundice

Obstructive jaundice management - SlideShar

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  2. Obs. JObs. J Obstructive Jaundice - Whipple's OperationObstructive Jaundice - Whipple's Operation Anesthetic ManagementAnesthetic Management Munisha AgarwalMun O SlideShare utiliza cookies para otimizar a funcionalidade e o desempenho do site, assim como para apresentar publicidade mais relevante aos nossos usuários
  3. ation General :.
  4. al pain along with fevers and jaundice is suggestive of obstruction with an associated infection known as cholangitis. A malignant source of obstruction more often presents with painless jaundice and weight loss
  5. Patients with both acute and chronic biliary obstruction are at particular risk for hypotension after surgery to relieve the obstruction. 12 Complications are highly morbid and contribute to the high mortality. 54 Zollinger and Williams 55 found that patients with obstructive jaundice undergoing biliary surgery were more liable to a hypotensive.

Case Presentation Obstructive Jaundice Dr. Ravi Madhusudhana Professor Dr. Manjunath Post Graduate Dept of Anaesthesiology. SDUMC, Kolar. * * * * Identification of - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 465c18-NWFm Obstructive jaundice is the type of jaundice resulting from obstruction of bile flow to the duodenum from the biliary tract. Also called mechanical, cholestatic jaundice or surgical jaundice.. As a reminder, Jaundice, or icterus refers to the yellowish discoloration of the skin, sclerae, and mucous membranes caused by retention of bilirubin and/or its conjugates Obstructive Jaundice | Part 2 |#jaundice

Obstructive jaundice is a condition in which there is a blockage of the flow of bile out of the liver. This results in redirection of excess bile and its by-products into the blood, and bile excretion from the body is incomplete. Bilirubin, a component of bile, is yellow, which gives the characteristic yellow appearance of jaundice in the skin, eyes, and mucous membranes An in depth look at Obstructive Jaundice as part of our Surgery themeIn this video: Introduction & MCQ'sPathophysiology and histologySymptoms and historyClin.. Obstructive Jaundice. Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Obstructive jaundice is a specific type of jaundice, where symptoms develop due to a narrowed or blocked bile duct or pancreatic duct, preventing the normal drainage of bile from.

In this video we will study about case presentation on Obstructive Jaundice for final year mbbs Surgery Practical Exam#ObstructiveJaundive⭐FOR Notes ,PDFs, C.. 17 Abdoulaye Korse Balde et al.: Obstructive Jaundice, Study of 33 Cases in Department of Visceral Surgery, Donka National Hospital reasons. [1] Despite the difference in recognition of the nature of obstructive jaundice in different medical centers, finding the causative factor responsible the obstruction is a

Background: Patients with obstructive jaundice have various pathophysiological changes that affect the liver, kidney, heart, and the immune system. There is considerable controversy as to whether temporary relief of biliary obstruction prior to major definitive surgery (pre-operative biliary drainage) is of any benefit to the patient #surgicaleducator #obstructivejaundice #introduction #usmle #babysurgeon #surgicaltutorSubscription Link: http://youtube.com/c/surgicaleducator?sub_confirmat.. Obstructive jaundice occurs when the bile is unable to flow out of the liver due to blockage. The result of this is that the excess bile is redirected into the bloodstream along with its by-products. Thus there is an incomplete excretion of bile. The byproducts of bile include bilirubin, derived pigment from dead blood cells (red) Biliary obstruction associated with pancreatitis is observed most commonly in patients with dilated pancreatic ducts due to either inflammation with fibrosis of the pancreas or a pseudocyst. Notably, intravenous feedings predispose patients to bile stasis and a clinical picture of obstructive jaundice Methods: Twentyfive patients with obstructive jaundice (mean serum total bilirubin 175.0 ± 120.8 μmol/L), who accepted volume expansion and were hemodynamically stable after induction of.

Background: Obstructive jaundice is a common problem in daily clinical practice. Understanding completely the pathophysiological changes in obstructive jaundice remains a challenge for planning current and future management. Data sources: A PubMed was searched for relevant articles published up to August 2016. The effect of obstructive jaundice. View Obstructive jaundice_finalised.ppt from CT 012 at Asia Pacific University of Technology and Innovation. BY DR. Allah Obhayo Unar Department of surgery IMS, MSU Must know Must do Must know - Ho This chapter outlines the approach to the patient with jaundice and highlights the importance of a thorough history with physical examination. The role of various non-invasive and invasive investigations is discussed, together with an overview on how to manage various surgical causes of obstructive jaundice Unlimited access to the largest e-library of professional videos, images, documents, courses. Connect with peers 250,000+ Healthcare Professionals from 180 countries. Upload and share your own cases, ask questions and discuss. Create your professional profile and build personal recognition worldwide. Stay up-to-date with innovative techniques.

Surgery in patients with obstructive jaundice is generally considered to be associated with a higher incidence of complications and mortality. Therefore, it poses a considerable challenge to the. Obstructive jaundice which can be either due to intra-hepatic cholestasis or extra-hepatic biliary obstruction is amenable to surgical treatment. Hence, it is also called surgical jaundice. It is difficult to diagnose the type and cause of obstruction on clinical grounds alone. But there are certain clinical criterion's associated with it • An 82-year-old patient with obstructive jaundice secondary to simple renal cyst also suffered pain and vomiting from partial duodenal obstruction. The symptoms were relieved by aspiration of 1,750 ml of fluid. This reaccumulated over a five-year period when aspiration again relieved his symptoms,..

Biliary atresia- Obstructive jaundice/ Pediatric surger

If the obstruction does not clear on its own, you may need surgery to relieve the obstruction. Treatment for complete obstruction. If nothing is able to pass through your intestine, you'll usually need surgery to relieve the blockage. The procedure you have will depend on what's causing the obstruction and which part of your intestine is affected Start studying Surgery obstructive jaundice, pancreatitis, vascular. Learn vocabulary, terms, and more with flashcards, games, and other study tools incidence of obstructive jaundice found to be 48.5 years in the study done by Shukla et al.19 In a study by Sharma et al mean age was 62.5.18 Other studies also have reported similar age groups to be involved in obstructive jaundice.15-17 Obstructive jaundice is one of the 118, 58.71% 83, 41.29% Malignant etiology Benign etiolog Obstructive jaundice is a common condition that may result from malignant or benign diseases. Before endoscopic biliary stenting, which was introduced in the early 1980s, surgery was the primary treatment for cases of biliary obstruction. Surgical options for obstructive jaundice included Whipple procedure with hepaticojejunostomy, cholecystojejunostomy, choledochojejunostomy, or other. Download. OBSTRUCTIVE JAUNDICE: UNDERSTANDING THE PATHOPHYSIOLOGY. Dr Ketan Vagholkar. SURGERY | REVIEW ARTICLE OBSTRUCTIVE JAUNDICE: UNDERSTANDING THE PATHOPHYSIOLOGY Ketan Vagholkar∗,1 ∗ Department of Surgery, D.Y.Patil University school of Medicine, Navi Mumbai-400706. MS

Surgical jaundice - SlideShar

  1. Obstructive jaundice and preoperative biliary drainage. Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumor as well as a proximal bile duct tumor (Klatskin tumor) is associated with a higher risk of postoperative complications than in non-jaundiced patients
  2. Introduction . Non Hodgkin lymphoma (NHL) presenting with obstructive jaundice is a rare occurrence. Because of rarity of combination, it is seldom considered in differential diagnosis of patients presenting with obstructive jaundice. It is considered treatable due to the chemosensitive nature of the disease and the recent advances in chemotherapy. <i>Case Series</i>
  3. ed 76 patients undergoing surgery for obstructive jaundice. It was the routine practice of the surgeons perfor

'obstructive jaundice' on SlideShar

Rahman et al also in the bile, leading to a higher rate of gallstones which noted a 71% malignant cause of obstructive jaundice are noted predisposition to these conditions leading to but reported gallstones as the commonest benign cause biliary obstruction and even gall bladder cancer.12-14 of obstructive jaundice.16 All patients with chronic. At the time of presentation, 261 patients (76.3%) exhibited signs and symptoms of obstructive jaundice. These patients were divided into the aforementioned three groups based on the treatment they received (Figure 1). In 14 patients with obstructive jaundice, endoscopic stent implantation and/or surgery were impossible due to poor patient. The causes of jaundice in the first weeks of life can becategorised into hematologic, enzymatic/metabolic, infectiousand obstructive.[1,2] Diagnostic tests are definitive and surgicaltreatment options do not have a role in the first threecategories.Operative cholangiography is the next logical stepin the diagnosis of obstructive causes.[2,3] Obstructive jaundiceis caused by an interruption to. Aim: To evaluate the effect of preoperative biliary drainage (PBD) on obstructive jaundice resulting from malignant tumors. Methods: According to the requirements of Cochrane systematic review, studies in the English language were retrieved from MEDLINE and Embase databases from 1995 to 2009 with the key word preoperative biliary drainage The most common cause of obstructive jaundice is choledocholithiasis, but malignant neoplasms should be suspected in older patients presenting with painless jaundice. 6 Progressive anorexia, weight loss, deterioration in performance, and/or vague abdominal pain should prompt suspicion of a malignant etiology

Pathophysiology of obstructive jaundiceObstructive jaundice -case presentation - YouTube

Obstructive jaundice Anesthesia Managemen

  1. Acute renal failure occurs in 8 to 10% of patients requiring surgery for relief of obstructive jaundice and contributes to eventual mortality in 70 to 80% of those who develop it. A major factor.
  2. Wait RB, Kahng KU. Renal failure complicating obstructive jaundice. Am J Surg 1989; 157:256. Grande L, Garcia-Valdecasas JC, Fuster J, et al. Obstructive jaundice and wound healing. Br J Surg 1990; 77:440. Shirahatti RG, Alphonso N, Joshi RM, et al. Palliative surgery in malignant obstructive jaundice: prognostic indicators of early mortality
  3. Jaundice-Pataints complain of yellow colour urine, eyes or body which depends on severity of jaundice which may be mild, moderate or severe.This level of jaundice depends on types i.e-:hepatocellular (medical) or obstructive (surgical-extrahepatic) and level of obstruction like complete or incomplete blockage of hepatic or bile ducts

PPT - OBSTRUCTIVE JAUNDICE PowerPoint presentation free

Jaundice - American College of Surgeon

Obstructive jaundice and perioperative management

PPT - Case Presentation Obstructive Jaundice PowerPoint

Malignant diseases of obstructive jaundice include cholangiocarcinoma, Klastin tumour, carcinomas of the: pancreatic head, duodenum, Ampulla of Vater, gallbladder and lymph nodes at the porta. Benign diseases are biliary stricture, choledochal cyst, stenosis of the papilla, Mirizzi's syndrome and extra-hepatic biliary atresia. CBD exploration: After the exploration of the common bile duct. Obstructive Jaundice. David Fletcher. Search for more papers by this author. David Fletcher. James Stewart Professor of Surgery and Head of Department of Surgery The University of Melbourne, The Royal Melbourne Hospital Director of Neurosurgery and Director, The Melbourne Neuroscience Centre The Royal Melbourne Hospital, Melbourne. Obstructive jaundice is not a disease but a symptom of underlying liver conditions . The Department of Hepato-pancreato-biliary and Transplant Surgery at Singapore General Hospital explains the types of obstructive jaundice and its causes

Obstructive Jaundice: Causes, Symptoms and Treatment

The early, accurate, differential diagnosis of jaundice frequently presents so much difficulty as to remain a source of concern. To carry out a surgical procedure in the presence of jaundice due to hepatocellular disease is as undesirable as permitting biliary obstruction to go unrelieved during a prolonged period of medical investigation General Surgery. General surgery covers a wide arrange of clinical presentations and pathologies. Ranging from abdominal pain to PR bleeding, the spectrum of disease is large and involves numerous viscera. The core conditions run from the oesophagus and stomach to the small bowel, large bowel, and rectum. Start by learning how to approach the. Clinical Material From January, 1947, through December, 1959, surgery was performed for the relief of jaundice in 350 patients at the University Hospital. The causes of jaundice are shown in Figure 1. Two important aspects of surgical jaundice were noted from this group of patients 1. Confirm obstructive jaundice. • Tea coloured urine and pale stools. Sclera are yellow 2. Aetiology • Age- Young vs elderly. • Pain characteristic • Previous history of gallstone disease or billary colic sym • Previous history of surgery or procedure eg ERCP • Constitutional sym- LOA LOW malais Pancreatic cancer has a high metastatic capacity even in small tumours. The prognosis in pancreatic cancer remains very poor, with overall 5-year survival rate <5%. [start-clinical] Key Points. Pancreatic cancer will often present with a combination of obstructive jaundice, abdominal pain, or weight loss

Obstructive lung disease describes a range of conditions in which a person's airways are blocked. In this article, we look at its types, symptoms, diagnosis, and treatment Obstructive jaundice and pancreatic disease. Correspondence to: A M Smith andrewmalvernsmith@me.com. A 72 year old man was admitted under the surgical team with a short history of upper abdominal pain associated with vomiting, pruritis, pale stools, and dark urine. Four days earlier he had presented to his general practitioner with a four week. Obstructive jaundice is a medical emergency. Local guidelines should be in place and widely publicized to facilitate timely investigation and management and avoid complications. Management must involve a multidisciplinary team that can offer a full range of investigative techniques (cross-sectional imaging, percutaneous procedures, endoscopic. The need for radiological imaging in obstructive jaundice are: 5 (1) to confirm the presence of biliary system obstruction (i.e., to discriminate surgical versus medical jaundice) , (2) to determine the level of the obstruction, (3) to identify the specific cause of the obstruction, and (4) to provide complementary information relating to the underlying diagnosis (e.g., staging information in. Gupta AK, Singh A, Goel S. Profile and pattern of obstructive jaundice cases from tertiary care teaching hospital of Uttar Pradesh. Int Surg J. 2017:4(2):743-6. Kuberan K, Vijayalakshmi R, Chandrasekar G, Kumar AS. Saravana Kumar. A prospective study on etiology and management obstructive jaundice to extrahepatic biliary obstruction

Approach to Obstructive Jaundice Part 2 General

Obstructive jaundice. Obstructive jaundice occurs when there is an obstruction (blockage) in the bile duct, which prevents bilirubin from leaving the liver. This type of jaundice is usually caused by a gallstone, a tumour, or a cyst in the bile duct, or pancreas. Symptoms Symptoms of jaundice. Yellow skin is the main symptom of jaundice Obstructive jaundice is a clinical symptom that results from cholestasis. Cholestasiscan surgery, inflammation, or stones. Bile leak and abscess are common presentations either immediately after surgery or several months later. Diagnosis is usually made by chol-angiography. Brush cytology at the time of cholangiog The presentation of jaundice is a classic test of understanding of hepatic physiology and history is vital in working out the cause. Below, we give a structure to use to try to ascertain o Itching (in obstructive jaundice most commonly- deposition of bile acids in skin, NOT caused by bilirubin) o Abdominal pain:.

Obstructive jaundice is treated with surgery to remove the obstruction followed by medication; There is also medication induced jaundice, in other words, jaundice which occurs as a side effect to consuming certain medicines. In such cases the medicines are discontinued and alternative medicines are prescribed The most common causes of acute intestinal obstruction include adhesions, neoplasms, and herniation ().1 - 4, 6 Adhesions resulting from prior abdominal surgery are the predominant cause of.

Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels obstruction and hepatocellular damage, as well as pan partial K56.51. So given the above, if a patient has intestinal obstruction due to adhesions, only code K56.50, intestinal adhesions [bands], unspecified as to partial versus complete obstruction would be assigned, not two codes. Lastly, if intestinal obstruction is a complication of surgery, code K91.3-, may be warranted Endoscopic retrograde cholangiopancreatography is also used for the treatment of obstructive jaundice, and gallbladder or a pancreatic tumor. MRCP helps in visualizing the bile and the pancreatic ducts. The use of MRCP in diagnosing bile duct obstruction may avoid the use of unnecessary invasive procedures like ERCP

Obstructive Jaundice - Symptoms, Causes, Treatment

Results: Patients with jaundice due to hepatic parenchymal insufficiency (hepatocellular type) have a very dismal prognosis. For patients with biliary obstruction due to HCC (icteric type), the reported 1‐, 3‐ and 5‐year survival rates after curative resection were 57.1-100%, 20-47% and 6.7-45%, respectively Patients with obstructive jaundice and a bilirubin level of 40 to 250 μmol per liter (2.3 to 14.6 mg per deciliter) were randomly assigned to undergo either preoperative biliary drainage for 4 to. Managing jaundice. Once the cause of jaundice is known, your healthcare team can suggest ways to manage it. When jaundice is caused by a tumour or scarring, treatment may include: surgery to remove the obstruction; placing a thin plastic or metal tube (called a stent) to allow the bile to drain around the obstruction; Jaundice can cause itching

Obstructive Jaundice - YouTub

The Mirizzi syndrome refers to common hepatic duct obstruction caused by an extrinsic compression from an impacted stone in the cystic duct or Hartmann's pouch of the gallbladder. 1 The majority of the patients present the clinical triad of jaundice, fever, and right upper quadrant pain, showing in the laboratory evaluation elevations in the serum concentrations of alkaline phosphatase and. Jaundice (icterus) is the result of accumulation of bilirubin in the bloodstream and subsequent deposition in the skin, sclera, and mucous membranes. The normal range for total bilirubin is 3.4 to 20.0 micromol/L (0.2 to 1.2 mg/dL). Jaundice may not be clinically evident until serum levels >51 mi.. More complete obstruction causes duct dilation, jaundice, and, eventually, cholangitis (a bacterial infection). Stones that obstruct the ampulla of Vater can cause gallstone pancreatitis. Some patients (usually those who are older) present with biliary obstruction due to stones that have caused no symptoms previously Marrelli D, Caruso S, Pedrazzani C, et al. CA19-9 serum levels in obstructive jaundice: clinical value in benign and malignant conditions. Am J Surg. 2009 Sep. 198(3):333-9. . Bektas M, Dokmeci A, Cinar K, et al. Endoscopic management of biliary parasitic diseases. Dig Dis Sci. 2010 May. 55(5):1472-8. Obstructive jaundice is seldom a presenting feature of non-Hodgkin lymphoma (NHL). In the era predating aggressive chemotherapy, jaundice was often seen as a late manifestation of the disease. In 1961, Rosenberg et al. 1 reported on 1269 patients with NHL, 12·5 per cent of whom developed jaundice; in the majority of these patients the jaundice.

Obstructive jaundice occurs as a result of an obstruction in the bile duct. This prevents bilirubin from leaving the liver; Newborns. Jaundice is a common health issue in newborn infants. Around. A 55-day-old boy was transferred to our unit with intestinal obstruction and obstructive jaundice after two neonatal operations for duodenal atresia and intestinal malrotation. Abdominal ultrasound showed dilated intrahepatic and extrahepatic ducts with cut-off at the distal common bile duct (CBD). He underwent emergency laparotomy for adhesive intestinal obstruction with a contained abscess. Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients. Gut The effect of obstructive jaundice on the migration of reticuloendothelial cells and fibroblasts into early experimental granulomata not high or just slightly increased, but below the obstructive jaundice threshold of 20 mmHg = 2.94 kpa [29]. Common bile duct dilatation reported in the literature mostly fall into this type. Figure 3. Bile duct dilatation caused by stones in the common bile duct, with bile flowing through the gaps, no high bile duct pressure, and no jaundice

Choledocholithiasis- obstructive jaundiceObstructive jaundice