An obese but otherwise healthy 70-year-old lady presents with jaundice for 3 months, with no history of abdominal pain or vomiting. On examination, she has palpable gallbladder, there is scratch marks. On further questioning, she admits that she drinks 42 units of … takes paracetamol heavily for headache. Her blood results are as follows: Albumin 32… 456 (<110), ALT 88 (<48) Bilirubin 120 (<20) INR 1.5. GGT 400 (0-70) What is the most likely diagnosis?
سؤال مجاني 9 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة: C. Pancreatic cancer
Painless, progressive jaundice with a palpable gallbladder in an elderly patient is Courvoisier's sign. It suggests malignant distal obstruction, most often carcinoma of the head of the pancreas. The cholestatic labs (very high ALP/GGT and bilirubin, pruritus) fit an obstruction.
- In gallstone disease, the gallbladder is usually scarred and not palpable.
- The alcohol and paracetamol history is a distractor: paracetamol toxicity gives a hepatocellular picture, not a distended gallbladder.
- المصدر
- Surgical Recall biliary tract.pdf · p. 21
gallbladder - Afnan.pdf · p. 15 - المحاضرة
- Gallbladder Conditions · General Surgery · Module D
- ظهر في
- Surgery QB (Module D) p. 79 Q41