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    This document discusses a case of obstructive jaundice in a 57-year-old male patient. Initial testing showed elevated liver enzymes and bilirubin levels suggestive of biliary obstruction. Imaging revealed gallstones and a pancreatic mass. The leading diagnosis was pancreatic carcinoma or ampullary adenoma. The patient was scheduled for ERCP to further evaluate the biliary and pancreatic ducts and potentially place a stent. Periampullary tumors most commonly present with obstructive jaundice in patients aged 60-70. Treatment involves surgery like the Whipple procedure, with survival rates dependent on whether the cancer has spread to lymph nodes.

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    PancreaticCa

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    This document discusses a case of obstructive jaundice in a 57-year-old male patient. Initial testing showed elevated liver enzymes and bilirubin levels suggestive of biliary obstruction. Imaging revealed gallstones and a pancreatic mass. The leading diagnosis was pancreatic carcinoma or ampullary adenoma. The patient was scheduled for ERCP to further evaluate the biliary and pancreatic ducts and potentially place a stent. Periampullary tumors most commonly present with obstructive jaundice in patients aged 60-70. Treatment involves surgery like the Whipple procedure, with survival rates dependent on whether the cancer has spread to lymph nodes.

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    Download as PPS, PDF, TXT or read online from Scribd
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    52 views11 pages

    Pancreatic Ca

    Uploaded by

    salma007
    This document discusses a case of obstructive jaundice in a 57-year-old male patient. Initial testing showed elevated liver enzymes and bilirubin levels suggestive of biliary obstruction. Imaging revealed gallstones and a pancreatic mass. The leading diagnosis was pancreatic carcinoma or ampullary adenoma. The patient was scheduled for ERCP to further evaluate the biliary and pancreatic ducts and potentially place a stent. Periampullary tumors most commonly present with obstructive jaundice in patients aged 60-70. Treatment involves surgery like the Whipple procedure, with survival rates dependent on whether the cancer has spread to lymph nodes.

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    Download as PPS, PDF, TXT or read online from Scribd
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    of 11

    Obstructive Jaundice

    Michael Richardson
    8/20/04
    Obstructive jaundice
    • LC is a 57 yo male who presents with
    painless jaundice
    • Differential diagnosis (highest on list)
    – Pancreatic carcinoma
    – Ampullary adenoma
    – Gallstones
    – Liver disease
    • Initial imaging – U/S followed by CT
    Labs
    • H&H – 10.1/30.1
    • Amylase & Lipase – wnl
    • ALT/AST – 72/71
    • Alk phos – 701
    • T. bili/C. bili – 25.7/14.1
    • Cancer Ag 19-9 – 268 (nl <37)
    Biliary Dilatation
    Gallstone & Pancreatic duct
    Pancreatic mass
    Next step = ERCP
    • Endoscopic
    retrograde cholangio-
    pancreatography
    • Allows visualization of
    ampulla, imaging of
    bile and pancreatic
    ducts, and ampullary
    biopsy if desired
    ERCP (cont.)
    • ERCP also allows
    placement of stent for
    biliary decompression
    • Main limitation of
    ERCP is it’s inability
    to view extension of
    tumor into duodenum
    or pancreatic
    parenchyma
    Periampullary Tumors
    • Can originate from pancreas, CBD,
    duodenum, or ampulla
    • Average age of presentation = 60-70
    • Most common presentation = obstructive
    jaundice
    • Associated symptoms = nonspecific GI
    symptoms, steatorrhea, weight loss,
    fatigue
    Treatment & Prognosis
    • Whipple procedure
    • 5 yr survival = 65-
    80% if no nodes, 25-
    40% if positive nodes
    • 50% recur and
    ultimately die from ca
    • Better prognosis for
    those with true
    ampullary ca
    References
    • Whipple images taken from
    http://www.cancerhelp.co.uk/help/?page=3124
    • Clincal information from
    www.uptodate.com

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