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OBJEKTIF PEMBELAJARAN
Hyperbilirubineamia
Sebab
Excess haemolysis of RBC
EXCRETED
IN URINE
a. Viral Hepatitis
b. Cirrhosis liver
c. Tumor
d. Hepatotoxic drugs (eg. Aspirin,
Codeine, Halothane ect)
2.Hepatocellular Jaundice
3. Post Hepatic Jaundice
-Dikenali juga “Obstructive Jaundice”
- penyebab
-
Obstructive Jaundice
1.Kuning pada kulit dan selaput mukosa seperti
pada sclera.
2.Najis berwarna pucat-pale stool
3.Urin berwarna
gelap- dark colour urine “tea o”
4.Anorexia
5. Steatorrhoea
6.Pruritis
7.Abdomen pain
8.Demam
9.Xanthomatosis
Investigation
Serum bilirubin raised
Liver function test (LFT) increased
Urine bile Positive ( +ve )
Stool bile Negative – ve )
Stool for occult blood - +ve jika
disebabkan oleh tumor
Ultrasound
CT scan
Prothombin time (PT)
Diagnosis
Melalui sejarah pesakit
Jaundice + fever -Infective
Jaundice + pain -Tumor
Drug ingestion
- sejarah pesakit , Tab. Largactil,
Halothane.
Soalan
Treatment
1.Terpulang kepada penyebab
a) Stone di CBD canal bile duct
- Choledocholithotmy
b) Stone di cystic duct @ di Gall Bladder
- Cholecystectomy
c) Tumour di pancreas
- Choledochojejunostomy
(by pass daripada jejunum ke
CBD)
2. Jika PT prolonged treat patient with
injection vit K
Prognosis
Jika Stone - baik
JUMPA LAGI…