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]

• Malaise

  Patients with acute DILI who are symptomatic may report malaise, low-grade fever, anorexia, nausea, vomiting, right upper quadrant pain, jaundice, acholic stools, or dark urine. [hindawi.com]

  In GH, non-specific symptoms are the rule, usually including malaise, anorexia, and fever. Manifestat ions of profound cholestasis or hepatic failure are rare[77]. [ncbi.nlm.nih.gov]

• Pallor

  • Marked splenomegaly- Cirrhosis + portal HTN or lymphoproliferative disease • Stools - loose, pale, bulky and offensive, sticky to the pan & non flushable -Our Case – O/E – Pallor +, icteric, B/L pedal edema. 1 x 1 cm firm lymph node in left axilla [slideshare.net]

  Pseudo jaundice may be found in black patients with pigmented sclera, from carotinemia, uremia (a sallow yellowish pallor), and quinacrine (a yellow-green color). Causes of jaundice can be classified into pre-hepatic, hepatic or post hepatic. [ptolemy.ca]

• Abnormal Breathing

  breathing sounds, wheezing Inflammation of the gall bladder, difficulty in swallowing, faecal incontinence, jaundice, liver disorder Inflammation of the skin, fungal infection of the skin, skin peeling, infection of the wound after an operation Muscle [et.glosbe.com]

• 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]

  Surgery in jaundiced patients is associated with a higher risk of postoperative complications compared with surgery in non jaundiced patients [ 13, 14 ]. [bmcresnotes.biomedcentral.com]

• Hepatomegaly

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

  Examination revealed hepatomegaly and ascites. Laboratory investigations revealed hyperbilirubinemia with cholestasis. [elsevier.es]

  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]

• Neonatal Jaundice

  Risk of kernicterus in newborns with neonatal jaundice References:[1] We list the most important complications. The selection is not exhaustive. [amboss.com]

  "Neonatal jaundice". Oxford Handbook of Clinical Specialties. Oxford University Press. [en.wikipedia.org]

  […] epidemic jaundice were not discovered until the middle of the 20th century. et Siis enne lõpphääletust lõpetame. en Cases of neonatal thrombocytopenia, or foetal or neonatal jaundice have been reported with maternal thiazide therapy et Kao mu dušširuumis [et.glosbe.com]

  Newborn babies will begin to appear jaundiced when they have more than 5 mg/dL of bilirubin in their blood. It is important to recognize and treat neonatal jaundice because high levels of bilirubin can cause permanent damage to a baby's brain. [emedicinehealth.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]

  Icterus - cutaneous jaundice is usually seen at serum concentrations of about 85.5 μmol/L but scleral icterus can be seen at concentrations as low as 34.2 μmol/L. Pyrexia - suggests infection or cholecystitis. [patient.info]

• Liver Tenderness

  tenderness en Eyes and skin are jaundiced. et Et kõnealuse tootja müügimaht siseturul oli suur, otsustati pidada kogumüüki usaldusväärseks en I think I've got jaundice. et Seevastu ei ole dokumendis sõnagagi mainitud väljakutseid, millega seisavad silmitsi [et.glosbe.com]

• Corneal Opacity

  […] tired, and have dark urine, pale faces, yellowish skin and/or eyes (jaundice), and other symptoms possibly requiring hospitalisation en Very rare side effects Changes in the lining of the uterus (endometrium), endometrial cancer, alopecia, transient corneal [et.glosbe.com]

• Muscle Weakness

  […] 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]

  Physical Examination – 1) S/o chronic liver disease, temporal & proximal muscle weakness. 2) S/o Cholesterol deposition (Xanthomas, xanthelasmas) flat or slightly raised, yellow and soft, usually around the eyes, in the Palmar creases, below the breast [slideshare.net]

• 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]

• Alopecia

  They may be extremely tired, and have dark urine, pale faces, yellowish skin and/or eyes (jaundice), and other symptoms possibly requiring hospitalisation en Very rare side effects Changes in the lining of the uterus (endometrium), endometrial cancer, alopecia [et.glosbe.com]

• Tremor

  […] jaundice. et Nõukogu tuleb viivitamata kokku en Side effects reported rarely (more than # in # patients and less than # in # patients) are: Decrease in white blood cells, decrease in blood platelet count Low blood sugar Agitation, anxiety, depression, tremor [et.glosbe.com]

  Flapping tremor. Splenomegaly. Finger clubbing. Ascites. Peripheral oedema. Abdominal examination: In viral hepatitis the liver is slightly enlarged and tender. The liver edge in cirrhosis is firm. An irregular liver edge suggests malignant disease. [patient.info]

  A fine tremor was noted; asterixis of hands was intermittently present. Initial laboratory evaluation revealed a hemoglobin of 12.1 g/dL (13.5‐16.5), platelet count of 115 k/µL (150‐400), and white blood cell count of 11.8 k/µL (4.5‐11). [onlinelibrary.wiley.com]

• Agitation

  […] the Limpert boy had a bit of jaundice. et Nõukogu tuleb viivitamata kokku en Side effects reported rarely (more than # in # patients and less than # in # patients) are: Decrease in white blood cells, decrease in blood platelet count Low blood sugar Agitation [et.glosbe.com]

  But epinephrine also has many adverse reactions, such as agitation, restlessness, headache, tachycardia, hypertension, and some significantly more dangerous conditions including myocardial ischemia, ventricular arrhythmia, cerebral hemorrhage and pulmonary [jsms.sch.ac.kr]

• Dark Urine

  Urinary urobilinogen Other significant findings Prehepatic jaundice Dark ↑↑ Normal Normal ↑↑ (no darkening of urine, but dark urine may occur in the case of hemoglobinuria) Hemolytic markers Anemia Intrahepatic jaundice Pale, clay-colored (rarely dark [amboss.com]

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

  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]

  ‘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]

• Hepatocellular Carcinoma

  We report a case of a recurrent intraductal hepatocellular carcinoma. The patient initially underwent surgical resection of segment five HCC nine months ago with clear margins. [ncbi.nlm.nih.gov]

  Okuda K: Clinical aspects of hepatocellular carcinoma: analysis of 134 cases; in Okuda K, Peters RL (eds): Hepatocellular Carcinoma. New York, Wiley, 1976, pp 387–436. Lin TY, Chen KM, Chen YR, Lin WSJ, Wang TH, Sung JL: Icteric type hepatoma. [karger.com]

However, effective biliary drainage and treatment of HCC such as with TACE or radiotherapy improves survival. [ncbi.nlm.nih.gov]

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]

These observations reflect differences in etiological spectrum from one centre to another. [bmcresnotes.biomedcentral.com]

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

Liver Biopsy Helpful in intrahepatic cholestasis to evaluate for various possible underlying etiologies. Treatment / Management Management of cholestatic jaundice widely depends upon underlying etiology and type of cholestasis. [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]

Epidemiological characteristics of the colorectal carcinoma on the territory of the municipality of Cacak. Acta Medica Medianae 2002; 41(3):29-36. [cyberleninka.org]

[…] 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]

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]

Supplements of calcium and vitamin D are often taken if the cholestasis persists, but they are not very effective in preventing loss of bone tissue. [msdmanuals.com]