Etiology of obstructive jaundice: a comparative study

ABSTRACT

1. To re-appraise the etiology of obstructive jaundice. 2. To raise high index of suspicion for malignancy in cases of obstructive jaundice. DESIGN: retrospective study. SETTING: department of surgery, Rawalpindi General Hospital. PERIOD Jan 1990 to Dec 1994. PATIENTS AND METHODS: 360 cases which presented with extra hepatic biliary tract disease, 52 had obstructive jaundice, the etiology of which is evaluated and compared with that of European published data. common bile duct stones accounted for obstruction in 21 patients [40.3%], whereas carcinoma of the pancreas produced obstruction in 14 patients [27%]. Carcinoma of gall bladder presented with obstructive jaundice in 8 patients [15.3%]. Pancreatitis caused obstruction in 4 [7.6%] and secondaries produced obstructive jaundice in 2 patients [3.8%]. The incidence of malignancy was 48.1% in this study in comparison with two studies from United Kingdom which shows an incidence of 59% and 29.45%. Choice of various operative procedures performed is also evaluated. CONCLUSIONS: It is concluded that malignancy accounts to almost half of the cases of obstructive jaundice which is higher than in Western countries