A 14-year-old patient with jaundice and distal CBD obstruction
Patient presented with jaundice for 1.5 month. associated with dark colour urine, wt loss no nausea or vomiting, no fever.
Patient had dermatological disease since childhood.
Her investigation was T.S.B=9.9mg/dl, direct 7.7, alkaline phosphatase=540 IU/L.
Virology screen was negative.
CBC was normal.
ESR=22.
OGD not been done because she had chest infection and unfit for G.A.
U/S shown liver enlarged in size, fatty texture, smooth outline .dilated intra and extra hepatic biliary tree, dilated CBD=12mm dilated to its most distal end, no stone.
GB grossly dilated with normal wall thickness, no stone.
Spleen enlarged in size = 19 cm ,with normal texture.
