Naveena, R (2014) Clinical spectrum of presentation of obstructive jaundice in inflammation, stone disease and malignancy. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
INTRODUCTION: Obstructive jaundice or surgical jaundice or extrahepatic cholestatic jaundice occurs due to obstruction to the outflow of bile.It can be intrahepatic or extrahepatic obstruction. The disease has a high morbidity and mortality rates. OBJECTIVES: This study was done to analyse the etiological spectrum of obstructive jaundice, the clinical presentation, relevance of the available investigations and management for benign and malignant jaundice in our set up. METHODS: In my study I have included 50 patients who were diagnosed to have obstructive jaundice and were receiving treatment in Tirunelveli Medical College Hospital. All of them were investigated biochemically and radiologically and managed appropriately. RESULTS: In this study male : female incidence of the disease was found to be 1.3 : 1 indicating the high prevalence in males. The most commonly affected age group was 50-60 years with the mean age of 52.5 years. Malignant disease was found to be more common in elderly males. About 54% presented with yellowish discoloration of the skin and sclera as the chief complaint and about 70% cases had malignant etiology.The most common benign etiology was found to be choledocholithiasis and the most common malignancy was found to be periampullary carcinoma. The most common morbidity due to the disease was cachexia. Ultrasound abdomen confirmed the presence of biliary obstruction in all cases and CT abdomen identified the etiology in almost all cases. 50% of the cases were treated with surgery and 32% received palliative treatment in the form of chemotherapy and radiotherapy and ascetic fluid tapping. CONCLUSION: Malignant jaundice occurs most commonly in elderly males. Periampullary carcinoma is the most common malignant etiology in our set up. USG and CT abdomen are valuable investigations in confirming the diagnosis and detection of the etiology. 3 patients died showing a mortality rate of 6% in this study. Early diagnosis and treatment plays an important role in the prognosis of the patients with obstructive jaundice.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Obstructive jaundice ; etiology ; malignant jaundice ; palliation. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 07 Jul 2018 01:44 |
| Last Modified: | 07 Jul 2018 01:44 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8686 |
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