Case of obstructive jaundice due to ca of head of pancreas.
Case- a 60 year old male patient presenting with yellowish discolouration of eyes and urine for last 9 months and anorexia for 6 months.
The yellowish discolouration was gradually feeling for about 3 months and afterward there is diminution of yellowish discolouration for about 30 days. But yellowish discolouration recurring since a month
Patient passing clay coloured stools since the onset of yellowish discolouration of eyes and urine and complains of itchiness all over the body with complaints of mass in the right upper half of abdomen for last 5 months.
Negative history of vomiting or haematemesis, alteration of bowel habit, and no urinary complaint, and no other systemic symptoms.
Examination- poor nutrition, pallor is present, patient deeply jaundiced, normal shape of abdomen, normal umbilicus, liver and spleen not palpable.
There is a lump in the right hypochondriac region extending to the epochs attic region
The swelling which is palpable appears to be the palpable gall bladder
Investigation - LFT
USG - hepatobiliary
Findings - High conjugated bilirubin
High Serum alkaline phosphatase
Prolonged prothrombin time
Normal alt and ast although serum proteins were low
Treatment - currently no symptoms and signs of disseminated disease - will be going for curative surgery
Exploratory laparotomy for confirmation followed by Whipple's operation once checking if the patient is fit for the operation and after all the necessary preoperative procedures.