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Gastrointestinal System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"Jaundice is an uncommon complaint in adults which may potentially signify serious disease.\n\nProgressive painless jaundice (as encountered here) is particularly ominous, given its classical association with malignancy; key etiologies to keep in mind include carcinoma of the ampulla of vater, extrahepatic cholangiocarcinoma, and adenocarcinoma of the pancreatic head.\n\nThat said, it should also be appreciated that painless jaundice is also the most common presentation associated with a resectable and curable malignancy; moreover, it does not always imply malignancy, as certain benign diseases (such as autoimmune hepatitis) may also present in this fashion.\n\nThe remainder of the history and examination does not provide clues towards a likely causative etiology; the next step should be properly targeted investigations, starting with a liver profile and imaging of the liver and biliary tree.\n\nThe liver profile reveals the presence of direct hyperbilirubinemia along with elevated alkaline pho"}]}

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