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Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

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The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
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Acute Pancreatitis II: Clinical Manifestations and Management01:30

Acute Pancreatitis II: Clinical Manifestations and Management

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Urinary Tract Calculi III: Medical Management01:30

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

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Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
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Chronic Pancreatitis I: Introduction01:24

Chronic Pancreatitis I: Introduction

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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Related Experiment Video

Updated: Jul 28, 2025

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
03:56

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

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Choledocholithiasis Can Present with Marked Transaminases Elevation: Systematic Review and Meta-Analysis.

Mouhand F H Mohamed1, Khaled Elfert2, Neha Wadhavkar3

  • 1Division of Medicine, The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA. mouhand@brown.edu.

Digestive Diseases and Sciences
|June 3, 2023
PubMed
Summary

Common bile duct stones can cause severe liver injury, with over a third of patients showing elevated liver enzymes (ALT/AST > 500 IU/L). Extreme elevations (ALT/AST > 1000 IU/L) are also observed in choledocholithiasis cases.

Keywords:
CBDCholedocholithiasisGallstoneLiver injurySevere transaminase

Related Experiment Videos

Last Updated: Jul 28, 2025

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
03:56

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

2.4K

Area of Science:

  • Hepatology
  • Gastroenterology
  • Internal Medicine

Background:

  • Extreme transaminase elevation (>1000 IU/L) typically indicates hepatocellular injury from ischemia, drugs, or viral infections.
  • Acute choledocholithiasis (common bile duct stones) can mimic severe hepatocellular injury with marked transaminase elevation, contrary to its usual cholestatic presentation.

Conclusions:

  • This meta-analysis is the first to report the prevalence of severe hepatocellular injury in patients with common bile duct stones.
  • Approximately one-third of choledocholithiasis patients present with ALT/AST > 500 IU/L, and levels > 1000 IU/L are not uncommon.
  • In cases with clear evidence of choledocholithiasis, extensive work-up for alternative causes of severe transaminase elevation may be unnecessary.