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JAUNDICE
UNIV VAN PTA
Pretoria Academic Hospital
GASTROENTEROLOGY
Dr Obedy Mwantembe
23/05/2017
1
JAUNDICE

23/05/2017
Symptom
2
Three Causes



23/05/2017
Prehepatic
Hepatic
Post Hepatic
3
HISTORY




Duration and onset
Drug intake/history
The Progression
Associated Features
Pruritus
 Colour of stool
 Anaemia

23/05/2017
4
PHYSICAL
EXAMINATION





Confirm Jaundice
Xanthelasma
Scratch Marks
Masses – Liver/Spleen
Gall Bladder
Murphy’s Sign
 Courvoisier’s Law
 Courvoisier’s Sign

23/05/2017
5
LABORATORY

Biochemistry
ALP
 GGT


SEROLOGY

Anti smooth muscle antibodies
 Total

Anti-mitochondria antibodies
 Total
23/05/2017
IgG
IgM
6
GASTROENTEROLOGIS
T



23/05/2017
SONAR
MRCP
ERCP
7
SONAR




23/05/2017
Available
Cost effective
Not invasive
Observer/ operator dependent
8
SONAR



Masses
Fluids / Mixed fluids
OBSTRUCTION

23/05/2017
Dilated Ducts
9
MRCP
23/05/2017
10
ERCP

Endoscopic Retrograde Cholangiopancreatography
Diagnostic
 Therapeutic

23/05/2017
11
ERCP

Sphincterotomy



FBC/INR
Stone Extraction
Stenting
Obstructive jaundice
 Pancreatitis


23/05/2017
Cyst Drainage
12
DRAINAGE


23/05/2017
After attempted Stenting
PTC
13
PERCUTANEOUS

23/05/2017
Percutaneous Transhepatic
Cholangiography
14
WELCOME TO THE
DEPARTMENT


23/05/2017
EVERY DAY
Mornings
15
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