“A CLINICO-RADIOLOGICAL PRESENTATION IN PATIENTS WITH OBSTRUCTIVE JAUNDICE: A PROSPECTIVE OBSERVATIONAL STUDY”

Abstract

Introduction: Obstructive jaundice is a common surgical problem. Occurs due to both benign and malignant conditions. Evaluation in patients with obstructive jaundice was a challenging problem. Presentation of obstructive jaundice patients is late and mostly present after the disease becomes advanced or uncurable. Aims And Objectives: To assess age and sex pattern, clinical presentation and radiological and biochemical pattern in obstructive jaundice patients. Material And Methods: 100 patients with obstructive jaundice were studied. Proformas form waslled and assessment of demographic and clinical patterns in benign and malignant obstructive were observed and radiological ndings in benign and malignant obstructive were carried out to assess the operability. Result: we enrolled 100 patients, 18 were male and 82 female having mean age was 52.58 yr. All patients have icterus, 60% having a lump in abdomen, 31% have pruritus. Gallbladder was palpable in 40% patients at which most were due to pancreatic and Periampullary malignancy. Our study reveals the most common overall and benign cause of biliary tract obstruction was CBD stone(33%) and most common in malignant is gall bladder carcinoma(31%) followed by Periampullary carcinoma(17%). CBD stone treated by CBD exploration(85%) and palliative treatment by ERCP(15%) and rest of benign conditions are completely treatable. Among malignant causes gallbladder carcinoma treated by radical cholecystectomy (16%), cholangiocarcinoma were mostly inoperable, Periampullary carcinoma by Whipple's procedure(25%). Conclusion: Malignant causes of obstructive jaundice outnumbered the benign causes. Most common overall and benign cause was Choleldocholithiasis and malignant was gallbladder carcinoma followed by Periampullary carcinoma. Benign causes were prevalent in younger age groups (31-40 yr) and malignant in older age groups(61-70 yr).Common presentation of obstructive jaundice was icterus and palpable gallbladder was indicative of malignant etiology. Ultrasound followed by MRCP/ERCP and CT scan was the investigation of choice. Benign conditions have better outcome and cure rate while malignant conditions were inoperable (83%).