This document discusses obstructive jaundice, including its definition, types, causes, clinical features, diagnosis, and treatment. Obstructive jaundice is caused by a blockage of bile flow from the liver, resulting in yellowing of the skin and eyes due to high bilirubin levels. It may be due to gallstones, tumors, or other issues that cause either intra- or extra-hepatic duct obstruction. Patients experience jaundice, itching, pale stools, and weight loss. Diagnosis involves lab tests, imaging like ultrasound or MRCP, and sometimes ERCP. Treatment depends on the underlying cause but may include drainage procedures or surgery. Pre-operative management focuses on hydration, cl
This document discusses obstructive jaundice, including its definition, types, causes, clinical features, diagnosis, and treatment. Obstructive jaundice is caused by a blockage of bile flow from the liver, resulting in yellowing of the skin and eyes due to high bilirubin levels. It may be due to gallstones, tumors, or other issues that cause either intra- or extra-hepatic duct obstruction. Patients experience jaundice, itching, pale stools, and weight loss. Diagnosis involves lab tests, imaging like ultrasound or MRCP, and sometimes ERCP. Treatment depends on the underlying cause but may include drainage procedures or surgery. Pre-operative management focuses on hydration, cl
This document discusses obstructive jaundice, including its definition, types, causes, clinical features, diagnosis, and treatment. Obstructive jaundice is caused by a blockage of bile flow from the liver, resulting in yellowing of the skin and eyes due to high bilirubin levels. It may be due to gallstones, tumors, or other issues that cause either intra- or extra-hepatic duct obstruction. Patients experience jaundice, itching, pale stools, and weight loss. Diagnosis involves lab tests, imaging like ultrasound or MRCP, and sometimes ERCP. Treatment depends on the underlying cause but may include drainage procedures or surgery. Pre-operative management focuses on hydration, cl
This document discusses obstructive jaundice, including its definition, types, causes, clinical features, diagnosis, and treatment. Obstructive jaundice is caused by a blockage of bile flow from the liver, resulting in yellowing of the skin and eyes due to high bilirubin levels. It may be due to gallstones, tumors, or other issues that cause either intra- or extra-hepatic duct obstruction. Patients experience jaundice, itching, pale stools, and weight loss. Diagnosis involves lab tests, imaging like ultrasound or MRCP, and sometimes ERCP. Treatment depends on the underlying cause but may include drainage procedures or surgery. Pre-operative management focuses on hydration, cl
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Obstructive
Jaundice
DR. ANMOL CHAUDHARY
DEPT OF GENERAL SURGERY Definition
Yellowish discolouration of skin, sclera & epithelial surfaces due to
raised bilirubin concentration in the blood. Types of Jaundice
Pre hepatic jaundice
Excess production of bilirubin - Haemolytic anaemia eg. Spherocytosis, Thalassaemia, incompatible or massive blood transmission. Hepatic jaundice Defective processing of bilirubin in the liver. eg. Viral Hepatitis, toxic hepatitis, cirrhosis of liver, Malignancy. Cholestatic drugs eg. Chlorpromazin, methyl testosterone, PAS. Post hepatic or obstructive jaundice Blocked excretion of bile form the liver eg. Stone in the CBD or on CA pancreas etc. Aetiology Congenital causes Biliary atresia Choledochus cyst Acquired causes Intra Luminal obstruction (within the lumen of CBD). CBD calculus Worm in CBD Broken T-tube Aetiology (Cont…) Intra mural obstruction within the wall of the CBD. Cholangitis Cholangiocarcinoma Traumatic Stricture Ligation of Bile duct Bile duct injury Choledochus cyst Extra Mural obstruction (from outside the CBD ). Metastasis at porta hepatis. CA gall bladder > metastatic lymph node > growth migration through the cystic duct CA head of pancreas Periampullary carcinoma Mirrizi’s syndrome Chronic pancreatitis – Mass in head of pancreas, calculi Clinical features of Obstructive Jaundice Jaundice Progressive or intermittent Painless or painful. Pyrexia Pruritis Steatorrhoea Clay coloured or pale stool Dark urine Weight reduction Distaste for food. Swelling or lump in the abdomen. Bleeding Diathesis Diagnosis
Stool examination – Colour – Stercobilinogen absent. Hypotonic Duodenography USG abdomen CT abdomen MRCP ERCP PTC Endoscopic sonography (EUS) Problems of Surgery in the Jaundiced patients
1. Obstruction & Sepsis
2. Impaired clotting 3. Risk of renal failure resulting from dehydration. 4. Impaired resistance to infection. Pre Operative Preparation In Obstructive Jaundice
1. Good Hydration 2. Correction of impaired clotting - Vitamin K - FFP 3. Antibiotics 4. Endoscopic Drainage of bile duct - Stone removal - Stenting 5. Precutaneous Transhepatic Cholangiogram & Drainage. Treatment
