DOI: http://dx.doi.org/10.18203/2349-2902.isj20192060

Clinical profile of patients with obstructive jaundice: a surgeon’s perspectives

Zubair Afzal Khan

Abstract


Background: There are various causes of obstructive jaundice, choledocholithiasis– the commonest. Patients with obstructive jaundice usually present with complain of yellow skin and eyes, pale stools, dark coloured urine, jaundice, and pruritus.Abdominal pain often misleading for diagnosis. The objectives of the study were to study the clinical profile of patients with obstructive jaundice.

Methods: The study included the patients clinically diagnosed as suffering from obstructive jaundice. Thorough history taking and clinical examination was done. Patients undergone for various laboratory investigations, and radiological evaluation.

Results: A total 201 patients were included in the present study. Males are more affected (55.72%) as compared to females. Elder age groups (>65 years; and 55-65 years) were commonly affected. 58.71% of patients have malignant causes for development of obstructive jaundice as compared to benign causes in 41.29% of patients. Choledocholithiasis (30.35%) is the commonest cause of obstructive jaundice followed by carcinoma of pancreas (25.87%). Jaundice is the commonest symptom of presentation.

Conclusions: Better understanding of the clinical profile in the patients with obstructive jaundice will facilitate appropriate management and lead to improved survival.


Keywords


Obstructive jaundice, Choledocholithiasis, Clinical profile

Full Text:

PDF

References


Shah R, John S. Cholestatic Jaundice (Cholestasis, Cholestatic Hepatitis). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2019. Available at: https://www.ncbi.nlm.nih.gov/books/NBK48-2279/. Accessed on 16 January 2019.

Bertani H, Frazzoni M, Mangiafico S, Caruso A, Manno M, Mirante VG, et al. Cholangiocarcinoma and malignant bile duct obstruction: A review of last decades advances in therapeutic endoscopy. World J Gastrointest Endosc. 2015;7(6):582–92.

Clarke DL, Pillay Y, Anderson F, Thomson SR. The current standard of care in the periprocedural management of the patient with obstructive jaundice. Ann R Coll Surg Engl. 2006;88(7):610–6.

Wang L, Yu WF. Obstructive jaundice and perioperative management. Acta Anaesthesiol Taiwan. 2014;52(1):22-9.

Lipsett PA, Pitt HA. Acute cholangitis. Front Biosci. 2003;8:s1229-39.

Sinanan MN. Acute cholangitis. Infect Dis Clin North Am. 1992;6:571-99.

Lipsett PA, Pitt HA. Acute cholangitis. Surg Clin North Am. 1990;70:1297-312.

Liu YH, Qiu ZD, Wang XG, Wang QN, Qu ZQ, Chen RX, et al. Praziquantel in clonorchiasis sinensis: a further evaluation of 100 cases. Chin Med J (Engl). 1982;95:89-94.

Khuroo MS, Zargar SA, Mahajan R. Hepatobiliary and pancreatic ascariasis in India. Lancet. 1990;335:1503-6.

Bonheur JL, Ells PF, Talavera F, Anand BS, Kapoor VK, Minocha A. Biliary Obstructi. MedScape. Available at: https://emedicine.medscape.com/ article/187001-overview. Last accessed on 16 January 2019.

Shrikhande SV, Barreto G, Shukla PJ. Pancreatic fistula after pancreaticoduodenectomy: the impact of a standardized technique of pancreatico-jejunostomy. Langenbecks Arch Surg. 2008;393:87-91.

Anand S, Panda C, Senapati AT, Behera MR, Thatei C. A study on incidence, clinical profile, and management of obstructive jaundice. J Evid Based Med Healthc. 2016;3:3139-45.

Shehu K, Babameto A, Xinxo S, Shehu B, Duni A, Taci S, et al. Relation between the Demographic and Clinical Characteristic and the Etiology of Obstructive Jaundice. Mediterranean J Med Sci. 2015;2:1-8.

Assy N, Jacob G, Spira G, Edoute Y. Diagnostic approach to patients with cholestatic jaundice. World J Gastroenterol. 1999;5(3):252–62.

Anand S, Panda C, Senapati AT, Behera MR, Thatei C. A study on incidence, clinical profile, and management of obstructive jaundice. J Evid Based Med Healthc. 2016;3(59):3139-45.

Hussain Talpur KA, Mahmood Malik A, Iqbal Memon A, Naeem Qureshi J, Khan Sangrasi A, Laghari AA. Biliary bypass surgery - Analysis of indications & outcome of different procedures. Pak J Med Sci. 2013;29(3):799-802.

Lawal D, Oluwole S, Makanjuola D, Adekunle M. Diagnosis, management and prognosis of obstructive jaundice in Ile-Ife, Nigeria. West Afr J Med. 1998;17(4):255-60.

Sharma MP, Ahuja V. Aetiological spectrum of obstructive jaundice and the diagnostic ability of ultrasonography: a clinician’s perspective. Trop Gastroenterol. 1999;20(4):167-9.

Shukla S, Kharat PR, Patbamniya N, Kumar K. Clinicopathological study on patients presenting with obstructive jaundice. Int Surg J. 2018;5:705-10.

Morse TS, Deterling RA Jr. Obstructive jaundice in the elderly patient. Am J Surg. 1962;104:587-90.

Gupta AK, Singh A, Goel S, Tank R. Profile and pattern of obstructive jaundice cases from a tertiary care teaching hospital of Uttar Pradesh. Int Surg J. 2017;4:743-6.

Siddique K, Ali Q, Mirza S, Jamil A, Ehsan A, Latif S, Malik AZ. Evaluation of the aetiological spectrum of obstructive jaundice. J Ayub Med Coll. 2008;20(4):62-6.

Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics. CA Cancer J Clin. 2009;59(4):225-49.

Bekele Z, Yifru A. Obstructive jaundice in adult Ethiopians in a referral hospital. Ethiopian Med J. 2000;38(4):267-75.

Foley WD, Quiroz FA. The role of sonography in imaging of the biliary tract. Ultrasound Q. 2007;23(2):123-35.

Agarwal JB, Patel RA. Surgical management of obstructive jaundice. J Ind Med Ass. 1974;62(12):414-6.

Nadkarni KM, Jahgirdar RR, Kagzi RS. Surgical obstructive jaundice – a study of 26 cases. J Postgraduate Med. 1981;27(1):33-9.

Warren KW, Christophil C, Armedariz R, Basu S. Current trends in the diagnosis and treatment of carcinoma of the pancreas. Am J Surg. 1983;145:813-8.

Mehrdad M, Seyed AM, Mohammad Taghi MS. Obstructive jaundice in Iran: factors affecting early outcome. Hepatobiliary Pancreat Dis Int. 2008;7:516–9.