EDITOR'S QUIZ: GI SNAPSHOT

A cause of cholestatic jaundice

P G Wheeler¹, A Atrey², A Healey², K M Taylor³, L R Jiao⁴

¹ William Harvey Hospital, Ashford, Kent, UK
² HPB surgery, Hammersmith Hospital, Division of SORA, Imperial College, London, UK
³ William Harvey Hospital, Ashford, Kent, UK
⁴ HPB surgery, Hammersmith Hospital, Division of SORA, Imperial College, London, UK

Correspondence to:
Correspondence to:
MrLong Rjiao
Senior Lecturer, Consultant Surgeon, HPB Surgery, Hammersmith Hospital, Division of SORA, Imperial College, Du Cane Rd, London W120NN, UK; l.jiao@imperial.ac.uk

Received 25 July 2006

Keywords: Sarcoidosis; obstructive jaundice

The first 150 words of the full text of this article appear below.

A 44-year-old Romanian woman with a history of asthma, epilepsy, non-insulin dependent diabetes mellitus, and depression presented with a gradual weight loss over 1 year, pruritis over 3 months, and a history of dark urine and pale stools for several weeks. She denied any abdominal pain.

Clinical examination revealed a soft, non-tender abdomen with no organomegaly. The patient was not clinically jaundiced and there was no lymphadenopathy.

Liver-function tests revealed raised bilirubin (34 µmol/l; normal range 1–14), alkaline phosphatase (449 IU/l; 4–105), and aspartate transaminase (203 IU/l; 1–31) Albumin was normal, and erythrocyte sedimentation rate was raised to 51 mm/h (normal range 0–20). Autoantibody screening tests (including anti-smooth muscle and anti-mitochondrial antibodies) was negative. Chest radiography was normal.

A diagnosis of obstructive jaundice was made and abdominal CT scanning was performed after an abdominal ultrasound scan was taken (figure 1). A subsequent ERCP showed a regular, smooth, bile-duct stricture, . . . [Full text of this article]

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