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SURGICAL JAUNDICE

INTRODUCTION. DEFINITIONEPIDEMIOLOGYAETIOLOGYPATHOGENESISCLINICAL FEATURESMANAGEMENTCOMPLICATIONSPROGNOSIS. DEFINITION . DEFINE JAUNDICETYPES OF JAUNDICE- CLASSIFYWITH RESPECT TO THE PATHOGENESIS- THE LIVER IS CENTRALPRE-HEPATIC, HEPATIC, POST-HEPATICOBSTRUCTIVE JAUNDICEAMENABLE/TREATABL

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SURGICAL JAUNDICE

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    1. SURGICAL JAUNDICE Dr. ADEFEMI O. AFOLABI HEPATOBILIARY & ENDOCRINE DIVISION DEPARTMENT OF SURGERY COLLEGE OF MEDICINE UNIVERSITY OF IBADAN, & UNVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA.

    2. INTRODUCTION DEFINITION EPIDEMIOLOGY AETIOLOGY PATHOGENESIS CLINICAL FEATURES MANAGEMENT COMPLICATIONS PROGNOSIS

    3. DEFINITION DEFINE JAUNDICE TYPES OF JAUNDICE- CLASSIFY WITH RESPECT TO THE PATHOGENESIS- THE LIVER IS CENTRAL PRE-HEPATIC, HEPATIC, POST-HEPATIC OBSTRUCTIVE JAUNDICE AMENABLE/TREATABLE BY SURGERY

    4. EPIDEMIOLOGY DISTRIBUTION GEOGRAPHICAL AGE GENDER

    5. AETIOLOGY AGE GENDER GEOGRAPHICAL LUMEN- INTRA-, MURAL, EXTRA- PNEMONIC- TINCABED

    6. AETIOLOGY CHOLEDOCHOLITHIASIS CHOLEDOCHAL CYST BILIARY ATRESIA & OTHER BILIARY ANATOMICAL VARIATIONS

    7. AETIOLOGY NEOPLASMS- CARCINOMA, HEAD OF PANCREAS, CHOLANGIOCARCINOMA, PERIAMPULLARY CARCINOMA, CARCINOMA OF THE DUODENUM LYMPHADENOPATHY-PORTA HEPATIS TRAUMATIC- POST CHOLECYSECTOMY

    8. PATHOGENESIS AETIOLOGICAL FACTORS-CALCULOUS, NEOPLASTIC BILIARY TREE OBSTRUCTION STASIS HEPATOCELLULAR DYSFUNCTION CHOLANGITIS MALABSORPTION

    9. CLINICAL FEATURES WITH RESPECT TO AETIOLOGY & THE EFFECTS OF OBSTRUCTION JAUNDICE, PRURITUS, DARK URINE, PALE STOOLS, PAIN/COLIC, WEIGHT LOSS, VOMITING, ANOREXIA, ANAEMIA, ABDOMINAL MASS, HEPATOMEGALY, GALL BLADDER DISTENSION, ASCITES

    10. MANAGEMENT CONFIRM CLINICAL DIAGNOSIS ASSESS PHYSIOLOGICAL STATUS INVESTIGATE FOR SURGERY

    11. INVESTIGATIONS ABDOMINAL ULTRASOUND ABDOMINAL CT SCAN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATO- -GRAPHY

    12. INVESTIGATIONS SERUM BILIRUBIN, ALKALINE PHOSPHATASE, AST, ALT, ALBUMIN, GLOBULIN, CHOLESTEROL PROTHOMBIN TIME (INR), PTTK URINALYSIS, SERUM E/U& Cr.,

    13. CT ABDOMEN

    14. CT ABDOMEN

    15. DISTENDED GALL BLADDER

    16. BILIARY BYPASS

    17. CT ABDOMEN(DA)

    18. LUNG METASTASES OF GALL BLADDER CANCER

    19. INVESTIGATIONS FULL BLOOD COUNT, GROUP & CROSS MATCH BLOOD HAEMOGLOBIN ELECTROPHORESIS BLOOD CULTURE CHEST X-RAY, ABDOMINAL X-RAY TRANSHEPATIC CHOLANGIOGRAPHY

    20. TREATMENT OPTIMISE THE PATIENT-CORRECT ANAEMIA, ELECTROLYTE ABNORMALITIES, REHYDRATE, BLEEDING DISORDER(VITAMIN K), NUTRITION-CHO, PROTEIN, BOWEL PREPARATION, PERIOPERATIVE ANTIBIOTICS

    21. TREATMENT CHOLEDOCHOLITHIASIS- INTRAOPERATIVE CHOLANGIGRAPHY CHOLECYSTECTOMY- OPEN/LAPAROSCOPIC, EXPLORATION OF COMMON BILE DUCT, INSERTION OF T-TUBE-MANAGEMENT OF TUBE, ENDOSCOPIC SPHINCTEROTOMY CARCINOMA- WHIPPLE’S PROCEDURE,

    22. T-TUBE CHOLANGIOGRAM

    23. PALLIATIVE TREATMENT ENDOSCOPIC INSERTION OF BILIARY STENT BYPASS SURGERY CHOLECYSTOJEJUNOSTOMY OR CHOLEDOCHOJEJUNOSTOMY,GASTROJEJUNOSTOMY, & JEJUNOJEJUNOSTOMY-SIDE TO SIDE OR ROUX-EN-Y

    24. COMPLICATIONS OF TREATMENT BLEEDING SEPTICAEMIA RENAL FAILURE ANASTOMOTIC DEHISCENCE OTHERS

    25. PROGNOSIS DEPENDS ON THE AETIOLOGY AND THE STAGE OF PRESENTATION

    26. CONCLUSIONS DO IT RIGHT THE FIRST TIME, BECAUSE LIFE IS NOT A DRESS REHEARSAL BOB GASS

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