Saturday, March 24, 2007

so why do you think his urine is dark....?

One of my pts today had a laparoscopic cholecystectomy with cholangiogram 3 days ago and they found a stone in the common bile duct but it could not be removed because the OR nurses had not prepared the equipment for it. Anyway the guy went for an ERCP to remove the stone yesterday adn today he was still jaundiced and his urine was dark. My chief resident asked me why his urine was dark...very easy answer: urine is dark due to increased direct bilirubin due to obstruction of the common biloe duct by stone....yeah I knwo it is pretty easy but when you are not expectign the question and your chief resident asks you "so do you think he has hematuria?" and you are not sure if he is pushing to the right direction or toward a trap, ti makes thigns a bit more difficult...

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