Impacted

Gastrointestinal System


Step 1: View Clinicals

{"ops":[{"insert":"A 48 year old man presents with worsening pain in the upper abdomen for 1 week, in a background of yellowish discoloration of the eyes and intermittent dark urine for 2 months. \n\nThere is no history of similar episodes in the past; or of other medical or surgical diseases. However, he confesses that he postponed seeking medical attention until now, as he was \u0022scared that he might have a serious illness.\u0022 He has never smoked, and only drinks socially. There is no history of sexual promiscuity, blood transfusions, or intravenous drug abuse.\n\nA complete blood count is only significant for a leukocytosis of 11,000\/mm3. A renal profile is within normal parameters, as are serum amylase and lipase levels.\n\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-S-046_en.png"}},{"insert":"\n"}]}

Step 2: Order Relevant Investigations

1. Liver profile
2. X-Ray Abdomen
3. Ultrasound Abdomen
4. MRCP

Step 3: Select Appropriate Management

1. ERCP with stenting
2. Cholecystectomy
3. Cholestyramine
4. Ursodeoxycholic acid

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