Seminar class all in the pancrease of the livet

Panscrese liver aemina

1. OBSTRUCTIVE JAUNDICE

2. OBSTRUCTIVE JAUNDICE _______________ Presented By: 1. Ayyub Rafiq Chougle 2. Itihas Bansode 3. Hrishikesh Bhalerao 4. Bhavni Saxena

3. Lorem ipsum dolor sit amt adipiscing elit. Maecenas porttitor congue massa. Lorem ipsum dolor sit amt adipiscing elit. Maecenas porttitor congue massa. CLINICAL PRESENTATION: SYMPTOMS : Jaundice (yellow skin/sclera) Bile can’t flow into the gut due to obstruction → Conjugated bilirubin leaks back into the blood → Deposits in skin and sclera. Dark Urine (Tea/Cola Color ) Conjugated bilirubin is water-soluble → Gets filtered by kidneys → Excreted in urine → Dark color . Pale/Clay- Colored Stool No bile pigments ( esp stercobilin) reach the intestine → Stool loses its normal brown color → Appears pale or clay-like.

4. Lorem ipsum dolor sit amt adipiscing elit. Maecenas porttitor congue massa. CLINICAL PRESENTATION: Pruritus (itching) Bile salts and acids accumulate in blood → Deposit in skin → Stimulate cutaneous nerve endings → Severe itching. RUQ/Epigastric Pain In gallstones: Obstruction causes biliary colic (spasm of duct walls) In cancer: Stretching of bile ducts, liver capsule, or invasion of nearby structures Weight Loss and Loss of Ap petite Seen mostly in pancreatic or biliary cancers Due to: Anorexia Malabsorption of fats Cachexia due to cancer metabolism Steatorrhea (fatty, foul-smelling stool) Fatigue, Weakness Fever ( may/ maynot ) Symptoms Cont..

5. CLINICAL PRESENTATION: SIGNS : Icterus Scleral icterus is seen when serum bil . > 2.5 mg% Dark Color Urine Seen if serum con. bil . > 0.4mg% COURVOISIER’S LAW “In a Patient with Jaundice if gall bladder is palpable, its not due to stones.” More likely to be due to malignancy Hydrohepatotic palpable Smooth, soft and non tender liver on palpation

6. CLINICAL PRESENTATION: Scratch Marks on Skin due to itching mainly at the back and forearms. Charcot’s Triad (In Acute Cholangitis) 1. Fever with Chills 2. Jaundice 3. RUQ Pain Reynold’s Pentad (In Acute Cholangitis) Charcot’s along with 4. Hypotention 5. Altered Mental Status Signs Cont..