Emergency Medicine PRACTICE
Jaundice: An Emergency Department Approach To Diagnosis And Management
March 2008; Volume 10 - Number 3
Authors: Wheatley M. & Heilpern K.
Peer Reviewers: Fiechtl J. & Jacobson S.
"You’re in the middle of a busy Monday afternoon shift. The next chart simply states “other complaint,” but one look at the patient tells you why he is here. The patient is a middle-aged male with no prior medical history who states that his family has been telling him his eyes are yellow for the last two to three weeks. He initially thought nothing of it but became concerned when the discoloration spread to his face. He also admits to occasional nausea, vomiting, poor appetite, weight loss, and diffuse itching.There is no history of fever, abdominal pain, heavy alcohol use, or recent acetaminophen ingestion. The physical exam is remarkable for icteric sclerae, jaundice of his face and upper chest, and mild non-tender hepatomegaly. Your history and physical have helped to develop the differential diagnosis related to the patient’s presentation; your challenge is directing the ED work-up so that the appropriate initial interventions can be made before disposition…"