J AUNDICE Mohammed Al- Rajeh & Shreef Al- Qahtani.

Slides:

Advertisements

Similar presentations

Gallbladder Disease Candice W. Laney Spring 2014.

Advertisements

Acute cholecystitis Diagnosis.

Gallbladder Disease Surgical Students Society of Melbourne, 2011 J. Bridie Mee RMH intern.

A case of upper abdo pain Joanna Wykes, FY2. You are an FY2 in general practice O A 45 year old female called Mary attends with two episodes of upper.

Gastrointestinal & Hepatic- Biliary Systems Chapter 5 Part II.

Pancreas & diabetes Željka Kušter Mentor: A. Žmegač Horvat.

Martina Rastovac Mentor: A. Žmegač Horvat. Actor Patrick Swayze died after a 20-month battle with pancreatic cancer. He was 57.Patrick Swayze.

Diseases of the Pancreas. 67 y old male with loss of appetite, gradual weight loss and dyspepsia. Recent onset of jaundice and dark urine.

Gallbladder and Pancreas Gallbladder  Anatomy and physiology  Calculous biliary disease  Benign acalculous biliary disease  Malignant biliary disease.

Biliary Tree Dr Bina Ravi Consultant and Associate Professor Surgery.

JAUNDICE Index Case Term 2.

Hepatobiliary Anatomy and Pathology

GALLSTONES Tanja Čujić Mentor: A. Žmegač Horvat. Anatomy of gallbladder and extrahepatic biliary tree Bile Helps the body digest fats Made in the liver.

Bernard M. Jaffe, M.D. Professor of Surgery, Emeritus

Benign biliary disease

Gall stone disease.

Chapter 12 Liver, Gallbladder, and Pancreas Diseases and Disorders

GALLSTONES By: Anika Khan Role #1030.

Biliary Tumors Cholangiocarcinoma and Cancer of the Gall Bladder

Nursing Care of Clients with Gallbladder, Liver and Pancreatic Disorders Chapter 27.

Care of the Client with Disorders of the Gallbladder ACC RNSG 1247.

Gallstone Disease.

THE GALLBLADDER AND THE BILIARY TREE BY MICHAEL BRILLANTES, MD, FPCS, FPSGS.

Vic Vernenkar, D.O. Department of Surgery St. Barnabas Hospital

MedPix Medical Image Database COW - Case of the Week Case Contributor: Jason Rexroad Affiliation: Civilian Medical Center.

Nursing Care of the Patient with a Disorder of the Gallbladder.

Biliary System Heartland Society of Gastroenterology Nurses and Associates Mary Ganley RN CGRN BSHA.

Ouch! I Think My Gall Bladder Hurts! Jody C. DiGiacomo, M.D., FACS Department of Surgery CentraState Medical Center.

Gallbladder & bile duct Carcinoma Dr. m. h.khosravi.

Mazen Hassanain. Bile duct Cancer Average age 60 years Ulcerative colitis is a common associated condition Subtypes: (1) periductal infiltrating, (2)

Care of the Client with Disorders of the Gallbladder ACC RNSG 1247.

DR.HAMAD ALQAHTANI Associate Professor Consultant Hepatobiliary Surgeon.

Diagnostic studies Blood Tests Imaging Modalities Reference: Schwartz’s Principles of Surgery 8 th Edition.

Digestive Disorders. Crohn’s Disease Chronic inflammatory bowel disease. Most common in small/large intestine. Causes: –Possible hereditary link to autoimmune.

Behzad Nakhaei, M.D., FICS Fellowship in HepatoBiliary Surgery Mc Gill University RUQ & Upper Abdomen Inflammation & Infection GallBladder & Biliary System.

Histopathology and cytology (MLHC-201) Faculty of allied medical sciences.

First Moscow Medical University Chair of faculty surgery # 2

PANCREATIC CANCER.

Gastrointestinal & Hepatic-Biliary Systems

Gallstones By Erfu Wang, Kaesh Chowdhory, Jae Yoon Chung, and Jun Young Kang.

Pathophysiology Complications Diagnosis Treatment

HPB DAY. Plan today 4 cases4 cases ImagesImages Present range of approachesPresent range of approaches DiscussionDiscussion.

Gallbladder Stones in Sickle Cell Anemia. SCA Complications Anemia Aplastic crisis Sequestration crisis Hemolytic crisis Dactylitis Painful crisis. VOC.

Faisal Al-Saif MBBS, FRCSC, ABS. - Acute Pancreatitis - Chronic Pancreatitis - Pancreatic Tumors - Pancreas Transplant.

FINAL DIAGNOSIS. PatientCholedocholithiasis Signs & symptoms -Painless jaundice -Tea-colored urine - (-) acholic stools - (-) fever - (-) weight loss.

Pancreatic Cancer L. Okolicsanyi G. Morana Pancreas Cancer l 2nd most common GI malignancy l 30,000 cases per year in US l 25,000 deaths per year l 4.

Pancreatic cancer.

Pancreatic Cancer: The Silent Killer By Suzanne Sica Class 2008.

Cholelithiasis. A Cause For Pain Background  Presence of gallstones in the gallbladder.  Spectrum ranges from asymptomatic, colic, cholangitis, choledocholithiasis,

Gall bladder and Biliary disease Dr.Umit Akyuz Gastroenterology Department Yeditepe University,Istanbul.

Department of Surgery. College of Medicine. Tikrit University. By Assisst.Prof. Dr.Makki.K.Allaw.

Biliary Imaging Ian Scharrer, MIV. Clinical Scenario A 46 year old woman presents to the clinic complaining of epigastric pain that she experiences after.

Tumors of the Biliary System. Anatomy Gallbladder Cancer Usually seen in the elderly Diagnosis at advanced stage, unless discovered incidentally during.

담도질환 Biliary stone disease Infectious/inflammatory disease Tumor

UNR ECHO PROJECT CLARK A. HARRISON, MD GASTROENTEROLOGY CONSULTANTS RENO, NEVADA GALLSTONE DISEASE: THE BIG PICTURE.

Conditions Affecting the Pancreas. Functions of the pancreas 1.The enzymes secreted in the pancreas help break down carbohydrates, fats, proteins, and.

Dr Amit Gupta Associate Professor Dept of Surgery

Treatment of Pancreatitis MLTTP (case study)

Chronic pancreatitis It is a chronic inflammatory disease due to repeated bouts of pancreatitis in which there is irreversible destruction of pancreatic.

ACUTE PANCREATITIS Acute inflammation of pancreas is one of causes of acute abd.pain. It’s a serious condition that leads to death in 10% of cases.

Pancreatic Cancer What you need to know to be able to educate your patients and their families.

Care of Patients with Problems of the Biliary System and Pancreas

Cholelithiasis Pathophysiology Pigment stones Cholesterol stones

DIABETES MELLITUS pathophysiology, diagnosis, treatment

Review of Anatomy and Physiology

Review of Anatomy and Physiology

Gall bladder nestled under the liver

Presentation transcript:

J AUNDICE Mohammed Al- Rajeh & Shreef Al- Qahtani.

A NATOMY OF B ILIARY T RACT

C ONDITIONS OF THE GALLBLADDER & BILLIARY TREE Colelithiasis : Stones in the gallbladder ( 85% cholesterol, 15% pigmented). Male : Female ratio (1:2 ). INCIDENCE: 10% Signs & Symptoms : - Asymptomatic - RUQ pain, tend to worse after eating ± nausea vomiting, biliary colic, resolves over few hours.

RISK FACTORS : Family history. Genetic factors. Native Americans and Hispanics. Obesity. Excess alcohol consumption Oral contraceptives. High fat, low fiber diet. Rapid weight loss. Hemolytic disorders (sickle cell anemia, hereditary spherocytosis). Liver cirrhosis. Diabetes. Female gender. Inflammatory bowel disease such as crohns.

DIAGNOSIS - Incidental - Abdominal films pick up to 15% - US. (procedure of choice) ;classic findings ? TREATMENT - Asymptomatic ; does not require cholecystectomy - Symptomatic requires cholecystectomy. - Medical treatment : ursodeoxycholic acid.

C HOLELITHIASIS. U LTRASOUND IMAGE OBTAINED WITH A 4-MH Z TRANSDUCER DEMONSTRATES A STONE IN THE GALLBLADDER NECK WITH TYPICAL ACOUSTIC SHADOW.

C OMPLICATIONS Infection or Rupture obstructive jaundice. Gall bladder cancer. Small bowel obstruction.( gallstone ileus) PROGNOSIS: Most have no symptoms. For those who do, the disorder is curable with surgery. About 10 to 15% of people with gall bladder stones will have associated choledocolithiasis.Also, after cholecystectomy, stones may recur in the bile duct.

A CUTE C HOLECYSTITIS Inflammation of the gallbladder wall, due to obstruction of cystic duct by gallstone. Sings & Symptoms : RUQ tenderness, nausea, vomiting, anorexia, fever. Murphy’s sign vs sonographic Murphy’s sign. Mass (in 1/3 of patients).

Labs : 1. Leukocytosis. 2. ↑ ALP, LFTs, Amylase & total bilirubin. 3. Ultrasound : findings ? 4. HIDA scan. Treatment : - NPO. - IV fluids, Antibiotics, analgesia. - Cholecystectomy.

C HOLEDOCHOLITHIASIS Stones in the CBD. Signs & symptoms : Epigastric or RUQ pain, jaundice (Charcot’s triad). Diagnosis : Labs : ↑ ALP, LFTs, Amylase & total bilirubin. ERCP : gold standard Treatment ERCP: with sphincterotomy If ERCP fails; CBD can be opened surgically.

ERCP, shows a dilated irregular common bile duct with multiple irregular filling defects.

C ARCINOMA OF THE PANCREAS

Adenocarcinoma ( 2/3 occurs in the head). Risk Factors : - Male gender, old age. - Tobacco use. - Diabetes. - Alcohol. - Chronic pancreatitis.

Signs & Symptoms: - Wt. loss - Jaundice (due to obstruction) - Epigastric pain (worsen in supine position & relived by lining forward, radiates to back). Diagnosis: - ↑ CEA (carcino-emberyonic antigen) or CA Ct scan (study of choice). - PTC and ERCP

Treatment : Head : Whipple procedure. (Most are not resectable at the time of Dx). Body/ Tail : Distal “near-total” panceatectomy. If unresectable : Palliative therapy. Postop. Chemotherapy: contraversial.

C HILEDOCAL CYSTS Cystic dilatations of the extrahepatic biliary tree, intrahepatic biliary or both. Congenital. More frequent in females (4:1 female:male ratio). Late teens or early 20s. Pain, jaundice, upper abdominal mass (classic triad). 20% risk of cancer if not removed. Typical scenario : 22 years old female, RUQ pain, jaundice Imaging studies: ( US, ERCP, MRCP Extra hepatic ductal dilation w/o any cause of obstruction.

Initial step should be to rule out metastatic disease. Treatment : Surgical Excision. - Cyst excision and cholecystectomy. - Bile duct is reconstructed: hepaticojejunostomy, hepaticoduodenostomy. * Most commonly used technique: Roux-en-Y hepaticojejunostomy.