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Surgery pp 191–199Cite as

New Onset of Painless Jaundice

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Abstract

A 68-year-old man presents to the emergency department complaining of fatigue and intermittent vague abdominal pain. He denies nausea or vomiting, but “does not have much of an appetite these days.” He reports having lost almost 20 lbs in the past 2 months. He was recently diagnosed with type 2 diabetes, but has no other medical problems and no previous surgeries. His stools have become lighter in color and his urine is much darker than before. His social history is negative for alcohol use, but he has a 50+ pack-year smoking history before quitting last year. He has no significant family history. On exam, he has a yellow hue to his eyes and tongue, along with scratch marks on his skin. A non-tender mass is palpated in the right upper quadrant of the abdomen. Laboratory testing reveals total and direct bilirubin of 18 mg/dL (normal 0.2–1.3 mg/dL) and 9.2 mg/dL (<0.3 mg/dL), respectively, and alkaline phosphatase elevated at 215 μ/L (33–131 μ/L). Liver transaminases are mildly elevated. CA 19-9 and CEA levels are normal.

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Author information

Authors and Affiliations

  1. Department of Surgery, UCLA, 757 Westwood Plaza, Mail room B711, Los Angeles, CA, 90095, USA

    James X. Wu MD

  2. Department of Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, Torrance, CA, 90509, USA

    Christian de Virgilio MD

  3. Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, 25, Torrance, CA, 90509, USA

    Danielle M. Hari MD

Authors
  1. James X. Wu MD
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  2. Christian de Virgilio MD
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  3. Danielle M. Hari MD
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Corresponding author

Correspondence to James X. Wu MD .

Editor information

Editors and Affiliations

  1. Department of Surgery, Harbor-UCLA Medical Center, Torrance, California, USA

    Christian de Virgilio

  2. General Surgery, Harbor-UCLA Medical Center, Torrance, California, USA

    Paul N. Frank

  3. Department of Surgery, University of California, Irvine, Orange, California, USA

    Areg Grigorian

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© 2015 Springer Science+Business Media New York

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Wu, J.X., de Virgilio, C., Hari, D.M. (2015). New Onset of Painless Jaundice. In: de Virgilio, C., Frank, P., Grigorian, A. (eds) Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1726-6_18

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  • DOI: https://doi.org/10.1007/978-1-4939-1726-6_18

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1725-9

  • Online ISBN: 978-1-4939-1726-6

  • eBook Packages: MedicineMedicine (R0)

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