We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Diagnosis of Cholestatic Jaundice-Reply

Murry G. Fischer, MD; Alvin M. Gelb, MD; Leonard A. Weingarten, MD
JAMA. 1981;246(24):2805-2806. doi:10.1001/jama.1981.03320240015007.
Text Size: A A A
Published online


In Reply.—  We agree with Drs LiCalzi and Storer that jaundiced patients with dilated biliary ducts require either surgical or radiological decompression. We have no quarrel with those who chose to follow our algorithm along the path where PTC follows when dilated ducts are demonstrated by sonography. The algorithm expresses our preference for this route when sonography shows only intrahepatic duct dilation.Certainly decompression by temporary PTC catheter drainage can be advantageous in very ill, deeply jaundiced patients, and permanent endobiliary decompression is a viable alternative treatment for the elderly or proved unresectable patient. However, they are incorrect in their impression that this cannot be accomplished via the ERCP route; it has been done.1,2We emphatically disagree that the diagnosis of ampullary or pancreatic head carcinoma is best made at the time of surgery. At the Lahey Clinic the operative diagnosis of carcinoma of the pancreatic head was later


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.