Obstructive jaundice

• Causes:

  • Common bile duct stone
  • Cholangitis
  • Bile duct strictures - recurrent stones, pancreatitis and autoimmune e.g. PSC
  • Malignancy - head of pancreas, cholangiocarcinoma
  • Pancreatitis
• lab investigation:

  • FBC - infection
  • CRP
  • U&Es
  • LFTs - obstructive picture
  • Clotting
  • Amylase if pancreatitis suspected
  • Urine dipstick - conjugated bilirubin
• Imaging:

  • First line - USS
  • If USS clear - MRCP
  • CT abdomen - suspected malignancy
• Intervention:

  • Sepsis six for unwell patients e.g. with cholangitis
  • Endoscopic removal of gallstones with ERCP
  • PTC second line