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An 81 year old female was admitted on acute medical take with a three week history of intermittent jaundice, vomiting, and unintentional subjective weight loss. Her clothes had become noticeably looser and she had been constipated for three days. She commented that her appetite had also become poor in this time period. There was no history of abdominal pain. She had not noticed any change in the colour of her stool or urine and had never previously had any similar symptoms. Her current medical problems included type II diabetes mellitus, biventricular heart failure, hypertension, and hyperlipidaemia. There was no history of renal or liver disease. Her usual medications included metformin, gliclazide, aspirin, frusemide, spironolactone, ramipril, amlodipine, isosorbide mononitrate, and simvastatin. There had been no recent additions to her medications.
She was a widow who lived alone but had a supportive daughter who lived next door. She was independent in all activities of daily living and prior to retirement at the age of 60 years, her occupation was as a factory assistant.
This tutorial is designed to revise the basic diagnosis and management strategies for biliary obstruction, with a particular view to underlying biliary malignancy. After working through this tutorial you should be familiar with the history and management of biliary tract malignancy, including:
diagnosis from blood tests as well as imaging
treatment options (surgical, endoscopic, chemotherapy, and radiotherapy)
This tutorial is hosted on BMJ Learning - the best available learning website for medical professionals from The BMJ Group.
To access the tutorial, please use [Take this module on BMJ Learning] link from the online article content box or table of contents.
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