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Author8 Posts
  #1

12. Six days after undergoing a laparoscopic cholecystectomy for acute cholecystitis, a 35-year-old woman comes to the physician because of fever and abdominal pain for 3 days. She is jaundiced. Her temperature is 38°C (100.4°F). Abdominal examination shows distention and incisions that are healing normally. Leukocyte count is 12,000/mm3, and total serum bilirubin level is 7.9 mg/dL. Which of the following is the most likely cause of the jaundice?

O A) Anesthetic-related hepatitis
O B) Common bile duct injury
O C) Fulminant hepatic failure
O D) Reaction to perioperative antibiotics
O E) Subhepatic abscess



A. Halothane causing hepatitis.
OR
B. CBD obstruction?



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  #2

CBD injury------>MCC lap.cholecystectomy


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"Obstacles are those frightful things you see when you take your EYES off your goal."

  #3

hepatitis?

there is no transaminases in this question...

smiling face

  #4

Tuscani wrote:
hepatitis?

there is no transaminases in this question...

smiling face


Yes, that was a second thought. My first instinct was CBD obstruction.

However she is jaundiced and has a high bili... there was no mention of alk phos, so that made me rethink my initial thought (CBD obstruction), but I guess thats the right answer.


___________________
Our greatest glory is not in never falling, but in rising every time we fall.

  #5

Such high level of bilirubin is mostly compatible with CBD obstruction, right?

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  #6

Six days is too mush for Halothane -related hepatitis.

  #7

delayyed halothane hepatitis at (7 days) ie type II

fever

leukocytosis

hepatic tenderness

jaundice ie elevated bilirubin

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  #8

Guys i am with u who go with CBD injury....becoz its a common complication of laproscopic cholecystectomy and its due to bile leakage in early period.We have a full picture of it.And we also hav a abdominal distension .

In halotane hepatitiss,distension is less likely than tenderness.Aand eosinophilia should be there.

Actually both options are potential answers.












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