Running behind on blog updates due to a recent plague visitation at the Rasnake house.
Two cases recently presented of patients with biliary tract complications. One was a patient with fever, jaundice, and leukocytosis with a history of previously instrumented biliary tract due to carcinoma - diagnosis was cholangitis.
Charcot's triad: rever, RUQ pain, and jaundice
Reynold's pentad: above three plus mental status change and hypotension.
Broad spectrum antibiotics to cover gram negative rods and anaerobes are important, but the key to management is decompression of the biliary tree via ERCP or other invasive methods.
The other case was a patient with a progressive mass in the vicinity of the pancreas but separate from pancreatic tissue that had been slowly enlarging over many months. Most likely diagnosis in this case is lymphoma pending tissue biopsy.
Friday I was out due to monthly residency review meeting - regular updates will resume this week.
Review of topics covered in morning report, M&m, and core conferences with links to supplemental reading material.
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