The role of various laboratory parameters associated with obstructive cholestatic jaundice in pancreatic tumor: A case report and literature review

Abstract

Introduction: Obstructive jaundice can be caused by pancreatic cancer, where most tumors block bilirubin excretion, and excess bilirubin accumulation causes jaundice. Jaundice occurs in more than 65% of pancreatic cancer patients. Jaundice is caused by the location of the tumor, usually located in the head of the pancreas, suppressing the bile ducts and creating a blockage characterized by an increase in bilirubin, especially direct bilirubin. Aspartate transaminase (AST) and alanine transaminase (ALT) may also be elevated in pancreatic cancer patients but to a lesser extent. Case Presentation: A 63-year-old male patient presented with ocular symptoms and generalized jaundice that had lasted for 2 months. Patients also complain of a bloated stomach and feel thin due to continued weight loss. The patient's stool was the color of putty and brown, like viscous urine. A physical examination revealed conjunctival jaundice in both eyes and hepatomegaly. Abdominal ultrasonography (USG) results suggest a pancreatic head mass with a dilated pancreatic duct and edema of the gallbladder with dilated extrahepatic bile duct (EHBD). Laboratory tests showed that the patient had elevated liver function, total bilirubin 11.90 mg/dl, direct bilirubin 8.29 mg/dl, SGOT 33 U/l, SGPT 54 U/l, and three positive urinary bilirubin values. It became clear that. The patient was diagnosed by observing cholestatic jaundice and the differential diagnosis of suspected pancreatic cancer of the head and cholangiocarcinoma. Conclusion: Examining laboratory parameters such as total bilirubin, especially direct bilirubin, liver enzymes SGOT, and SGPT may help localize obstructions, such as those caused by pancreatic tumors causing post hepatic obstructive jaundice.