If duodenal diverticula are frequently asymptomatic, they can occasionally present with obstructive jaundice in the absence of lithiasis or another obstructing lesion such as a tumor in a presentation called Lemmel's syndrome. [ncbi.nlm.nih.gov]

• Fatigue

  Fatigue: About 70% to 80% patients with chronic fatigue suffer from fatigue. Underlying abnormal serotonergic neurotransmission or neuroendocrine defects in the corticotrophin hormone axis are believed to be underlying etiology. [ncbi.nlm.nih.gov]

• Soft Tissue Mass

  Hepaticojejunostomy was performed and pathologic analysis of the conglomerated soft-tissue mass revealed chronic granulomatous inflammation with caseation of the lymph nodes. [ncbi.nlm.nih.gov]

• Multiple Organ Dysfunction Syndrome

  Bilirubin induces systemic inflammatory response syndrome which may lead to multiple organ dysfunction syndrome. [ncbi.nlm.nih.gov]

• Steatorrhea

  Some of these effects include : Steatorrhea (‘fatty stools’) Unintentional weight loss Softening of the bones (osteomalacia) Bleeding disorders Muscle pain and weakness Abnormal sensations like numbness and tingling Other late features of obstructive [healthhype.com]

  References:[10][8] Clinical features In addition to jaundice, the following signs may also indicate cholestasis: Pale, clay-colored (acholic) stool Darkening of urine Pruritus Fat malabsorption (steatorrhea, weight loss) References:[10][8][11][12] Diagnostics [amboss.com]

  Liver biopsy CT Ultrasound MRI Doppler flow Endoscopic cholangiography PTC ( percutaneous transhepatic cholangiography) ERCP (endoscopic retrograde cholangiopancretography) /cytology/biopsy Chronic bile stasis Pruritus - bile salts Steatorrhea - malabsorption [meddean.luc.edu]

  Stools may contain too much fat (a condition called steatorrhea) because bile cannot enter the intestine to help digest fat in foods. Fatty stools may be foul-smelling. [msdmanuals.com]

• Clay-Colored Stool

  Clay colored stool, weight loss and palpable abdominal mass were more common in malignant obstructive jaundice, whereas right upper abdominal pain was more common in benign obstructive jaundice. [bmcresnotes.biomedcentral.com]

  Abdominal pain and clay coloured stools were more frequent in patients with malignant disease. [ispub.com]

• Jaundice

  Our report highlights the varied aetiology of obstructive jaundice and the importance of including biliary ascariasis in the differential diagnosis of the jaundiced patient, especially from endemic areas. [ncbi.nlm.nih.gov]

• Hepatomegaly

  Hard & nodular hepatomegaly – ? metastatic malignancy. 6. [slideshare.net]

  Abdominal Pain Gallstones – stones are in the common bile duct Choledochal cysts (congenital anomalies of the bile duct) Pancreatitis Fever with Abdominal Pain Gallstones Choledochal cyst Stricture Abdominal Mass Pancreatitis Choledochal cyst Liver cancer Hepatomegaly [healthhype.com]

  Infants are jaundiced and often have dark urine (containing conjugated bilirubin), acholic stools, and hepatomegaly. [msdmanuals.com]

  They later develop firm hepatomegaly and splenomegaly. [emjreviews.com]

• Scleral Icterus

  […] carotenemia. carotenemia does not cause scleral icterus Hyperbilirubinemia per se has no patho-physiologic effect. [meddean.luc.edu]

  Definition Jaundice: yellowish discoloration of the skin, sclerae, and mucous membranes due to the deposition of bilirubin Scleral icterus: discoloration of the whites of the eyes, starting at serum bilirubin levels > 2–3 mg/dL Jaundice: discoloration [amboss.com]

  icterus is unacceptable to a patient et Võimaldamaks tõhusat ja ametlikku järelevalvet artikli # lõikes # osutatud sööda üle, rakendatakse järgmisi sätteid en It should not be used in patients with myasthenia gravis (a disease of the nerves causing muscle [et.glosbe.com]

  He also had scleral icterus. The remainder of his physical exam including the abdominal exam was normal. [hindawi.com]

  The presence of scleral icterus indicates a serum bilirubin of at least 3 mg/dL. The conjunctiva of the eye are one of the first tissues to change color as bilirubin levels rise in jaundice. This is sometimes referred to as scleral icterus. [en.m.wikipedia.org]

• Pruritus

  Prominent features of cholestasis are pruritus and malabsorption of fat and fat-soluble vitamins. [ncbi.nlm.nih.gov]

• Excoriation

  Bile acid resins (cholestyramine or colestipol) are the first line agents in moderate to severe pruritus particularly when associated with excoriations and disturbed sleep. Our patient was started on cholestyramine with symptom improvement. [hindawi.com]

  Pruritus - manifest by scratch marks (excoriation). This is a common but not universal feature (ranging from absent to severely disabling), the exact pathophysiology of which is not clearly understood. [patient.info]

  • Excoriations suggest prolonged cholestasis or high-grade biliary obstruction 23. [slideshare.net]

  Excoriations suggest prolonged cholestasis or high-grade biliary obstruction. Center SA. Diseases of the gallbladder and biliary tree. Vet Clin North Am Small Anim Pract. 2009 May. 39(3):543-98. [Medline]. Marrelli D, Caruso S, Pedrazzani C, et al. [emedicine.medscape.com]

• Dark Urine

  Symptoms of obstructive jaundice include the typical yellowing of jaundice as well as dark urine, pale feces, and itching. Also known as post-hepatic jaundice. [medicinenet.com]

  Symptoms & Effects of obstructive jaundice may include: Dark Urine Pale Faeces Itching Compare obstructive jaundice with hepatocellular jaundice and haemolytic jaundice. Click for pages about Digestion [ivyroses.com]

  Patients with medical jaundice will have yellowing of the skin, without dark urine or light-coloured stools. [healthxchange.sg]

  ‘Two thirds of pancreatic cancers develop in the head of the pancreas, and most patients present with progressive, obstructive jaundice with dark urine and pale stools.’ [oxforddictionaries.com]

• Kidney Failure

  Engelsk definition Functional KIDNEY FAILURE in patients with liver disease, usually LIVER CIRRHOSIS or portal hypertension (HYPERTENSION, PORTAL), and in the absence of intrinsic renal disease or kidney abnormality. [mesh.kib.ki.se]

Based on negative rheumatologic, autoimmune, and infectious causes workup, it was concluded that his cholestatic jaundice was related to Graves’ disease related thyrotoxicosis. [onlinelibrary.wiley.com]

[…] where indicated   • Sepsis Blood culture, full septic workup where indicated Table 2 Summary of recommendations and evidence base for strategies to improve outcome of patients with neonatal cholestasis RECOMMENDATION STRATEGY EVIDENCE Test at 2 weeks [cfp.ca]

Further radiological workup including CT (model GE CT/e ), MRCP (model GE Signa HDe 1.5T ) and ERCP or PTC was done as per the protocol as indicated mentioned in flow chart below. [ispub.com]

The treatment and diet for removing the calculus is almost the opposite of that required to pacify pitta and treat the jaundice. So the vaidyar first started the treatment to remove the calculus or kapha block. [newindianexpress.com]

OBJECTIVE: To evaluate the prognosis of different ways of drainage for patients with obstructive jaundice caused by hilar cholangiocarcinoma. [ncbi.nlm.nih.gov]

Furthermore, the prognosis of the patients was analyzed. [journalofhospitalmedicine.com]

No other major age differences were observed in the etiological groups. [journalofhospitalmedicine.com]

Once these abnormalities are identified, more extensive imaging tests can be performed to determine the nature, etiology, and level of obstruction. This information is essential for clinicians as they decide on management and treatment strategies. [ncbi.nlm.nih.gov]

Epidemiology[3] This generally relates to the epidemiology of underlying conditions. Extrahepatic cholestasis accounts for 70% of all cholestasis cases. [patient.info]

Outline of Discussion • Definition • Epidemiology • Classification • Pathophysiology • Clinical evaluation • Management 3. [slideshare.net]

[…] due to sickle cell disease Hereditary protoporphyria Bacterial infections, sepsis Cystic fibrosis Ductopenia Familial, drug-induced, chronic allograft rejection, Hodgkin disease, sarcoidosis, primary sclerosing cholangitis, primary biliary cholangitis Epidemiology [ncbi.nlm.nih.gov]

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. [ncbi.nlm.nih.gov]

Pathophysiology of obstructivejaundice 18. PATHOPHYSIOLOGY OFOBSTRUCTIVE JAUNDICEObstructive jaundice is a condition in which there is blockage of the flow of bileout of the liver. [slideshare.net]

References:[2][3][4][5][6][7][8][9] Pathophysiology Jaundice is due to an elevated level of serum bilirubin, which may be caused by prehepatic, intrahepatic, or posthepatic defects. [amboss.com]

Benjamin, “Biliary Tract Obstruction-Pathophysiology,” Blumgarts’ Surgery of the Liver and Biliary Tract, Vol. 1, Churchill Livingstone, Philadelphia, 1990; pp. 111-117. [ 8 ] R. B. [dx.doi.org]

Inflammation of the bile duct: This can prevent the secretion of bile and removal of bilirubin, causing jaundice. Obstruction of the bile duct: This prevents the liver from disposing of bilirubin. [medicalnewstoday.com]

Third, the patient has cirrhosis, preventing dilation of the ducts (the extrahepatic ducts, however, will still dilate if the obstruction is outside the liver). [surgwiki.com]

To prevent jaundice resulting from gallstone disease, eat a healthy, balanced diet and reduce your intake of fatty foods and alcohol. Ref: P16 [healthxchange.sg]

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 the bloodstream into the intestines. [nyp.org]

The stone blocking the bile duct prevents the bile containing bilirubin from reaching the digestive system. The lack of yellow bilirubin is what had made the stools white in colour. [newindianexpress.com]