Janni Laxman1, Patnala Mohan Patro2
BACKGROUND
Obstructive jaundice is defined as a condition occurring due to block in pathway
between the site of conjugation of bile in liver cells and entry of bile into
duodenum through the ampulla. This block may be intraheptic or extraheptic in
the duct. Evaluation and management of obstructive jaundice is a challenging
task to the surgeon owing the varied etiology and wide management option.
Common bile duct (CBD) varies in length from 5 to 15 cm with average diameter
of 6 mm. CBD can be divided in to four portions: supra duodenal, retro duodenal,
intra duodenal and intramural portion. The purpose of this study was to evaluate
the pattern of aetiology of obstructive jaundice in these parts and compare the
clinical and laboratory presentations with obstructive jaundice between benign
and malignant cases.
METHODS
This is a prospective analytical study. Patients with obstructive jaundice who
attended the outpatient department of Surgery, GITAM Institute of Medical
Sciences and Research, Visakhapatnam over a period of 24 months from
November 2017 to October 2019 were admitted and taken up for the study. A
total of 60 cases were studied.
RESULTS
Abdominal pain was a presenting symptom in 48 patients (80 %). Ninety five
percent of patients of benign and 50 % of patients of malignant aetiology
presented with this symptom. P value was found to be statistically significant for
this symptom. This means that jaundice with pain in abdomen is more common in
benign conditions while malignant conditions cause painless jaundice.
CONCLUSIONS
Malignant obstructive jaundice is most commonly seen in males while benign
conditions are more common in females. Benign conditions causing obstructive
jaundice is most common under 40 years of age while malignant obstructive
jaundice is commonly seen between 50 and 60 years of age.
