The examination of the patient revealed mild scleral icterus
, mild pedal edema.
Patients with cholangiocarcinoma most often present with painless jaundice and other signs of biliary obstruction: scleral icterus
, dark urine, clay-colored stools, or generalized pruritus.
His physical examination was significant for scleral icterus
, jaundice, and scratches on bilateral extremities due to severe pruritus.
He additionally complained of dark urine with sediments, dehydration, and scleral icterus
. Laboratory evaluation revealed an aspartate aminotransferase (AST) of 13,527 U/L, alanine aminotransferase (ALT) of 8,745 U/L, and ferritin of >40,000 ng/mL.
She was noted to have scleral icterus
, jaundiced palms, and scattered petechiae and purpura throughout her bilateral arms.
Upon admission he had complaints of nausea and vomiting and on exam had scleral icterus
. His admission laboratory values were notable for total bilirubin of 314.5 [micro]mol/L, direct bilirubin 217 [micro]mol/L, alkaline phosphatase 5.7 ukat/L, alanine aminotransferase 52.4 ukat/L, aspartate aminotransferase 64.4 ukat/L, international normalized ratio (INR) 2.1, and prothrombin time (PT) 32.3 seconds.
Examination was remarkable for scleral icterus
, ascites, and right upper quadrant tenderness, and the liver and spleen were not palpable.
A 61-year-old African American Female patient with a past medical history of sarcoidosis, hypertension, and COPD presented to the Emergency Department with unexpected weight loss, scleral icterus
, and a constant dull but sometimes sharp pain in the right upper epigastric quadrant and back.
Physical examination revealed conjunctival pallor and scleral icterus
. Cardiovascular and pulmonary examination were within normal limits.
The physical examination revealed jaundice, scleral icterus
, purpuric macules, superficial desquamation, gingivitis (FIGURE 1), and perifollicular hemorrhages with corkscrew hairs (FIGURES 2 AND 3).
Physical examination revealed scleral icterus
and mild epigastric area tenderness only.
Total bilirubin was 9.9mg/dL (<1.5mg/dL), and scleral icterus
was present on exam.