A CLINICAL STUDY ON OBSTRUCTIVE JAUNDICE

BACKGROUND Jaundice refers to yellowish discolouration of skin, sclera and mucous membranes due to increased concentration of bilirubin in body fluids. The pathological mechanism of jaundice can be classified into haemolytic, hepatocellular and obstructive. Jaundice that can be corrected with surgery is known as obstructive jaundice. Aims. To study the cases of obstructive jaundice and evaluation of clinical features, diagnosis and management. To study incidence in relation to age and sex of patients. To study various causes, pathological diagnosis in obstructive jaundice cases. To study the clinical presentation in various surgical jaundice patients. To study the treatment in various surgical jaundice patients. MATERIALS AND METHODS A prospective study was conducted at Government General Hospital, Kakinada. The study period was from August 2010 - August 2013. The study sample constituted 30 patients. Inclusion criteria - All patients admitted and diagnosed to have obstructive pattern of jaundice. RESULTS Most common cause of surgical jaundice is CBD calculi. Most common presentation is jaundice followed by loss of weight and loss of appetite. In benign causes, most common presentation is pain abdomen followed by jaundice. CONCLUSION In benign cases, the common symptom is pain abdomen and next is jaundice. In malignant cases, most common symptom is jaundice and next is loss of weight and appetite. There was significant high value of total bilirubin, direct bilirubin, alkaline phosphatase in malignant condition. Decreased value of albumin and altered coagulation profile seen in malignancy. ERCP is comparatively as good modality of treatment as open exploration of CBD in management of CBD calculi. In malignancy, early detection, staging, selection of patients are important to get benefit from curative resection; whereas in those not suitable for curative resection, good improvement in quality of life has been shown by palliative procedures.