The Value Of A Combined Study Of The Newer Laboratory Test In The Differential Diagnosis Of Toxic And Obstructive Jaundice Including Blood Phosphatase, Cholesterol Partition, Galactose Tolerance And Glucose Tolerance

1938 ◽  
Vol 5 (9) ◽  
pp. 597-606 ◽  
Author(s):  
Harry Shay ◽  
Philip Fieman
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Glucose Tolerance ◽  
Laboratory Test ◽  
Galactose Tolerance

Grey Scale Ultrasonography in the Differential Diagnosis of Obstructive Jaundice

1975 ◽  
pp. 125-131 ◽  
Author(s):  
K. J. W. Taylor ◽  
D. A. Carpenter ◽  
V. R. McCready ◽  
C. R. Hill
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Grey Scale

scholarly journals Necrotizing leukocytoclastic vasculitis mimicking necrotizing fasciitis: a case report

2016 ◽  
Vol 2 (3) ◽  
pp. 193
Author(s):  
Mehmet Salih Soylemez ◽  
Korhan Ozkan ◽  
Bulent Kılıc ◽  
Samet Erinc ◽  
Irfan Esenkaya ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Laboratory Test ◽  
Necrotizing Fasciitis ◽  
Immunofluorescence Microscopy ◽  
Leukocytoclastic Vasculitis ◽  
Maculopapular Rash ◽  
Skin Manifestation ◽  
Biopsy Specimens ◽  
Common Skin

<p>There are several subtypes of necrotizing leukocytoclastic vasculitis, which are classified according to their morphological features in biopsy specimens using immunofluorescence microscopy. Necrotizing leukocytoclastic vasculitis is limited to the skin, predominantly that of the lower extremities, and usually spares the palms and soles. The most common skin manifestation is palpable purpura. Other skin manifestations include maculopapular rash, bullae, papules, nodules, ulcers and livedo reticularis. There is no specific laboratory test to determine the diagnosis. There are various diseases presenting with these nonspecific symptoms, and a rapid differential diagnosis must be conducted, because the appropriate differentiation and diagnosis markedly influence the treatment strategy and survival of patients. In this study, we report a case of necrotizing leukocytoclastic vasculitis<strong> </strong>presenting with internal organ involvement and symptoms of necrotizing fasciitis, with emphasis on the clinical differentiation.</p>

SURGICAL EXPLORATION IN OBSTRUCTIVE JAUNDICE OF INFANCY

PEDIATRICS ◽  
1960 ◽  
Vol 26 (1) ◽  
pp. 27-35
Author(s):  
Thomas V. Santulli ◽  
Ruth C. Harris ◽  
Keith Reemtsma
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Bile Ducts ◽  
Frozen Section ◽  
Surgical Trauma ◽  
Bile Pigment ◽  
Biliary Cirrhosis ◽  
Intestinal Anastomoses ◽  
Surgical Exploration ◽  
Frozen Section Examination

From a review of 71 cases and an evaluation of frozen-section examinations of liver biopsies, the authors propose the following method of management of infants with prolonged obstructive jaundice. All patients are carefully selected on the basis of history, clinical findings and appropriate laboratory investigation. Laboratory studies found to aid in the differential diagnosis are: serial determinations of bilirubin (conjugated and unconjugated) in the serum, zinc sulfate turbidity test, cholesterol and cholesterol esters in serum, estimation of bile pigment in urine and stool, studies of the maternal and infant blood factors and erythrocyte fragility. Determinations that have not been useful in the differential diagnosis are: cholesterol esterase, alkaline phosphatase and cephalin fiocculation.19 The activity of transaminases in the serum may prove helpful and are currently under study. The measurement of the prothrombin time should be included in the preoperative studies. If the diagnosis is impossible by the age of 7 weeks, then surgical exploration is carried out. This consists of exposing the liver, taking a biopsy for frozen-section examination and performing a cholangiogram, if possible. With increasing experience, confidence has been acquired in interpretation of the frozen-section of the liver biopsy at this age. The authors are convinced of its value in helping the surgeon establish the diagnosis before proceeding with further exploration of the bile ducts. By this method of management, surgical exploration need not be delayed beyond 7 weeks of age. Thus a patient with congenital atresia of the bile ducts, who may be fortunate enough to have a correctable lesion, will not be deprived of the only possible chance of cure. At this age it is unlikely that biliary cirrhosis will have progressed to a severe degree. Admittedly, it would be preferable to explore such a case earlier, but more experience is needed in diagnosis by frozen-section examination at an earlier age. It does not appear that any patient with hepatitis or other non-surgical condition has been harmed either by the anesthesia or surgical trauma attendant on this limited procedure. One of the greatest advantages of the frozen-section examination has been the information provided to the surgeon at a crucial time during the exploration. With this information the surgeon should be able to avoid unnecessary exploration of the bile ducts and possible injury to patent ducts, as well as unnecessary biliary-intestinal anastomoses which have been performed in the past because of mistaken diagnoses.

THE FLUORESCENT ANTITOXIN TEST FOR THE IMMEDIATE DIAGNOSIS OF DIPHTHERIA

PEDIATRICS ◽  
1961 ◽  
Vol 27 (2) ◽  
pp. 214-218
Author(s):  
Jo Anne Whitaker ◽  
John D. Nelson ◽  
Chester W. Fink
Keyword(s):  
Differential Diagnosis ◽  
Laboratory Test ◽  
Clinical Judgment ◽  
Poor Quality ◽  
Fluorescent Staining ◽  
The Poor ◽  
Diphtheria Antitoxin ◽  
Early Case ◽  
The One

The recent increase in the incidence of diphtheria in our area stimulated the search for a reliable laboratory test for the immediate differential diagnosis of diphtheritic and non-diphtheritic membranous tonsillitis. Fluorescein-conjugated diphtheria antitoxin proved to be highly specific for staining toxigenic C. diphtheriae. Eight of nine patients with proved diphtheria had fluorescent organisms on a smear of exudate. The failure in the one case is attributed to the poor quality of the specimen obtained. An early case of diphtheria was detected by examination of family contacts of one of the patients in this series. The conjugated antitoxin does not result in fluorescent staining of nontoxigenic diphtheria bacilli on of other bacteria commonly found in the nasopharyngeal tract. Fluorescent staining of cultures suggests that only a small proportion of the potentially toxigenic diphtheria organisms are actually producing toxin at a given moment. The fluorescent antitoxin test can be performed within 1 hour. A positive result of the test is an absolute indication for antitoxin therapy. With a negative result the physician must still rely on his clinical judgment and cultural and virulence tests.

Interleukine-6 in the Differential Diagnosis of Extrahepatic Malignancy in Patients Presenting with Obstructive Jaundice

2009 ◽  
Vol 69 (5) ◽  
pp. AB139
Author(s):  
Ivanhoe Larracilla-Salazar ◽  
Angelica Hernandez-Guerrero ◽  
Juan Octavio Alonso-Larraga ◽  
Sergio R. Sobrino-Cossio ◽  
Jose-Guillermo De La Mora-Levy ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice

scholarly journals A Surgically Resected Pancreatic Schwannoma with Obstructive Jaundice with Special Reference to Differential Diagnosis from Other Cystic Lesions in the Pancreas

2018 ◽  
Vol 12 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Takayoshi Watanabe ◽  
Kenichiro Araki ◽  
Norihiro Ishii ◽  
Takamichi Igarashi ◽  
Akira Watanabe ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Protein Expression ◽  
Histopathological Examination ◽  
S100 Protein ◽  
Pancreatic Head ◽  
Pancreatic Tumors ◽  
Cystic Lesions ◽  
Cystic Tumors ◽  
Pancreatic Schwannoma

Pancreatic schwannomas are uncommon. About 60% of pancreatic schwannomas develop cystic lesions, and the differential diagnosis from other cystic pancreatic tumors is difficult. A 43-year-old man presented for evaluation of liver dysfunction detected during a medical checkup. Blood testing detected obstructive jaundice. A computed tomography scan revealed a well-defined polycystic tumor of about 5 cm at the pancreatic head. We performed surgical resection to treat the patient’s symptoms and facilitate long-term management. Histopathological examination revealed spindle-shaped cells. Immunohistochemical studies showed S100 protein expression and the absence of CD34 and c-kit protein expression. Finally, we diagnosed a schwannoma. Pancreatic schwannoma is usually asymptomatic. The present case presented with obstructive jaundice, which is reportedly a rare symptom. Pancreatic schwannomas should be considered as a differential diagnosis of pancreatic cystic tumors. Dilatation of the pancreatic duct and the 18-fluorodeoxyglucose positron emission tomography findings are important for the differential diagnosis.

scholarly journals MORPHOLOGICAL SUBSTANTIATION OF DIFFERENTIAL DIAGNOSIS OF JAUNDICE SYNDROME IN PATIENTS WITH ACUTE CHOLECYSTITIS

2021 ◽  
pp. 63-66
Author(s):  
T. I. Tamm ◽  
I. G. Zulfugarov ◽  
D.D. Ryabushenko
Keyword(s):  
Differential Diagnosis ◽  
Liver Cirrhosis ◽  
Obstructive Jaundice ◽  
Acute Cholecystitis ◽  
Morphological Changes ◽  
Gallbladder Wall ◽  
Results Of Treatment ◽  
Short Time ◽  
High Degree

Summary. Objective. To improve the results of treatment of patients with jaundice syndrome by improving the diagnosis quality of obstructive jaundice and improving methods of surgical treatment. Materials and methods. The results of diagnosis and treatment of 272 patients with benign jaundice syndrome admitted to the clinic on an urgent basis from 2010 to 2020 were analyzed. Differential diagnosis of the nature of jaundice and its cause was carried out according to ultrasound and ERCP. Results. Based on the revealed differences in the data of histostructures of the gallbladder wall in patients with acute cholecystitis, hepatitis, and liver cirrhosis, we determined ultrasound criteria for the differential diagnosis of mechanical and parenchymal jaundice. Ultrasound made it possible in a short time to determine the obstructive or parenchymal nature of jaundice by the nature of changes in the liver and the wall of the gallbladder. (Patent № 134089 dated April 25, 2019).In cases of mechanical origin of jaundice, ultrasound data helped to establish its cause and determine the tactics of treatment. Conclusion. 1. Morphological changes in the wall of the gallbladder in patients with acute cholecystitis, hepatitis and liver cirrhosis are qualitatively different from each other. 2. The combination of changes in the liver and the wall of the gallbladder revealed by ultrasound examination makes it possible to differentiate parenchymal and obstructive jaundice with a high degree of reliability.

Glucose Tolerance and Insulin and Gastric Inhibitory Polypeptide Responses following Intraduodenal Glucose Loading in Dogs with Obstructive Jaundice

1987 ◽  
Vol 4 (2) ◽  
pp. 76-81
Author(s):  
Kenichi Yoshiya ◽  
Takehira Yamamura ◽  
Yoshio Ishikawa ◽  
Joji Utsunomiya ◽  
Jiro Takemura ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Glucose Tolerance ◽  
Gastric Inhibitory Polypeptide ◽  
Glucose Loading
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