Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Jaundice, Obstructive”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources
PubMed1998

The pathogenetic role of endogenous angiotensin II in stress ulcer in obstructive jaundice rats.

OBJECTIVE: To investigate the pathogenetic role of endogenous angiotensin II (Ang II) in the mechanism of stress ulcer in obstructive jaundice rats and to detect the effect of angiotensin converting enzyme inhibitor (ACEI) on stress ulcer in obstructive jaundice rats. METHODS: After common bile duct ligation (CBDL) in Wistar rats, the content of plasma and gastric mucosal Ang II, gastric mucosal blood flow (GMBF) and gastric mucosal damage were measured, and the relationship among them was analyzed. RESULTS: The plasma Ang II contents increased much more significantly at 1, 3, 7 and 14 days following CBDL than those in non-CBDL rats (P < 0.05, < 0.01, < 0.01 and < 0.01, respectively). Within 120 minutes following cold-restraint stress, plasma and gastric mucosal Ang II contents were elevated, GMBF decreased, and ulcer index and gastric mucosal damage increased more significantly than those in non-cold-restraint stress rats (P < 0.05, < 0.05, < 0.01, < 0.01 and < 0.05, respectively). Administration of an ACEI, enalaprili, to CBDL rats (5 mg.kg-1.day-1, orally for two days) before stress reduced both the plasma and gastric mucosal Ang II levels, inhibited the decrease of GMBF and decreased ulcer index and gastric mucosal damage (P < 0.001, < 0.01, < 0.01, < 0.01 and < 0.05, respectively). CONCLUSION: The endogenous Ang II plays a significant pathogenetic role in the development of stress ulcer in obstructive jaundice rats, and ACEI may prevent stress ulcer.

Angiotensin II↗
PubMed1991

Mechanism of adaptive increase of respiratory enzymes in rat liver mitochondria during obstructive jaundice.

In order to elucidate the response of mitochondria to obstructive jaundice, we have examined the effects of common bile duct ligation on rat liver mitochondria. Although oxidative phosphorylation, especially respiratory control, of mitochondria was disturbed after the ligation, specific enzymic activities and subunit contents of the respiratory enzymes in mitochondria were significantly increased one week after the ligation. The immunostain for ubiquinol-cytochrome c oxidoreductase confirmed the increase in the subunit amounts in hepatocytes. This increase was associated with the increase in specific contents of DNA in mitochondria. These results suggest that mitochondrial biosynthesis is stimulated during obstructive jaundice.

Animals↗
PubMed2003

Role of bile in intestinal barrier function and its inhibitory effect on bacterial translocation in obstructive jaundice in rats.

BACKGROUND: Our previous study using genetically labeled Escherichia coli strain JNW14 revealed that obstructive jaundice promotes bacterial translocation in rats and that the absence of bile in the intestinal tract is considered to be a factor inducing bacterial translocation. The aim of this study was to investigate the role of bile and bile acids in intestinal barrier function against bacterial translocation. MATERIALS AND METHODS: Eight-week-old male specific-pathogen-free Wistar rats were subjected to ligation of their common bile ducts (CBDL). The CBDL rats were treated with bacitracin, neomycin sulfate, and streptomycin sulfate, and the intestinal tract was colonized with E. coli strain JNW14, which was genetically labeled with resistant markers against the above three antibiotics, to monitor the bacterial translocation. The rats were then administered saline, cholic acid (20 mg/100 g BW), taurocholic acid (TCA: 5-50 mg/100 BW), or bile (1.5-6 mL/day) via a duodenal catheter. The degree of bacterial translocation of E. coli strain JNW14 to the mesenteric lymph nodes was compared. Histopathological examination of the terminal ileum and intestinal permeability test using phenolsulfonphthalein was also performed. RESULTS: Both cholic acid and TCA showed no inhibitory effect on bacterial translocation at any of the doses tested in CBDL rats, although TCA significantly decreased the numbers of E. coli strain JNW14 in the cecum. However, bile administration reduced the numbers of E. coli strain JNW14 in the cecum and mesenteric lymph nodes in CBDL rats although the inhibitory effect was weak. The integrity and permeability of the intestinal mucosa were kept at normal levels by bile administration in CBDL rats whereas the morphological changes, such as villous atrophy, villous edema, and lacteal canal dilatation, were observed in other CBDL rats. CONCLUSION: Bile plays an important role in maintaining the intestinal barrier function to prevent the invasion of enteric bacteria to the underlying tissues, suggesting that the intestinal administration of bile to patients with obstructive jaundice is a useful way to reduce infectious complications by inhibiting bacterial translocation from the intestine to other organs.

Animals↗
PubMed1993

Obstructive jaundice--a diagnostic appraisal.

One hundred and eight suspected cases of obstructive jaundice (OJ) were analysed using ultrasonography, percutaneous transhepatic cholangiography (PTC) or Endoscopic retrograde cholangiopancreatography (ERCP) or both. Clinical evaluation had accuracy of 93% in identifying OJ and establishing aetiology in 62%, however, it lacked specificity. Ultrasonography was useful in differentiating obstructive jaundice from medical jaundice in 91% of cases. However, the cause and site of biliary obstruction could be identified in 55% and 46% respectively. PTC was helpful in detecting the site of obstruction in 80.4% and nature in 63% of cases. Its failures were mostly associated with the presence of metastasis in the liver. ERCP successfully attained cholangiography in 58% and pancreatogram in 70% of cases. Overall diagnostic yield of ERCP was 67% in view of additional endoscopic findings in 18 cases. The complications were occasional and could be managed effectively with medical treatment. This study suggests utility of clinical evaluation in OJ inspite of its poor specificity and comparative value of PTC and ERCP in establishing the site as well as nature of lesion.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1993

Multifocal mucus secreting papillary adenocarcinoma of the bile duct causing obstructive jaundice.

We present a 64-year-old Malay lady who had undergone a choledochoduodenostomy (CDD) two years ago for obstructive jaundice. She was admitted with jaundice and underwent ultrasonography, percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangio pancreatography (ERCP) and computed tomographic (CT) scanning of the liver and biliary tree. All the investigations confirmed a type IVa choledochal cyst. At operation, the grossly dilated biliary system was packed with a thick mucoid material and the mucosa of the bile ducts was visibly abnormal with scattered nodules. This mucoid material had caused occlusion of the entire biliary tree resulting in obstructive jaundice. To the best of our knowledge, this is probably the first report of obstructive jaundice caused by thick mucus. The peculiar management problems of this case and the risk of malignant change in choledochal cysts are discussed.

Adenocarcinoma, Papillary↗
PubMedDate not supplied

Perioperative renal protection in patients with obstructive jaundice using drug combinations.

BACKGROUND/AIMS: The effectiveness of dopamine alone or in combination with mannitol or furosemide in preventing postoperative renal dysfunction in patients with obstructive jaundice was assessed in this study. METHODOLOGY: Forty patients having obstructive jaundice were randomly allocated into 4 equal groups. Preoperative hydration was performed by infusing all patients 1L of 5% dextrose the night before surgery and another 1L in the morning before surgery. Intra- and postoperative maintenance of adequate intravascular volume was assured by fluid and blood replacement guided by the monitoring of central venous pressure urine output and blood pressure. The 1st group was kept as a control. The other 3 groups received dopamine 2.5 micrograms/kg/min for 2 postoperative days starting before surgery. The 2nd group was maintained on dopamine alone, while mannitol (0.25 g/kg), every 12 hours for 2 postoperative days, was added to the 3rd group. Similarly furosemide (1 mg/kg) every 12 hours for 2 postoperative days, was infused to the patients of the 4th group. Postoperative renal functions were assessed by 24-hour urine output, serum creatinine, creatinine clearance and urine to plasma osmolality ratio. RESULTS: All these tests did not show significant changes in the 1st, 2nd and 7th postoperative days. Only transient decreased creatinine clearance and elevated serum creatinine were observed in the patients of the 4th group in the 1st and 2nd postoperative days. This may be attributed to fluid imbalance induced by furosemide in these patients who were older than the other groups. CONCLUSIONS: The study showed that careful attention to perioperative hydration is the cornerstone in preserving adequate renal function following surgery in patients with obstructive jaundice. Administration of dopamine alone or in combination with mannitol or furosemide did not confer more renal protection.

Adult↗
PubMed2003

Obstructive jaundice caused by primary choledochal hydatid cyst mimicking radiologically choledochal cyst.

A 12-year-old girl with obstructive jaundice that was initially misinterpreted radiologically as having choledochal cyst is presented. A primary hydatid cyst in the wall of the common bile duct causing obstruction was found at operation. The authors emphasize that hydatid cyst should be included in the list of differential diagnoses of obstructive jaundice and cystic lesions located around the biliopancreatic junction in children.

Anastomosis, Roux-en-Y↗
PubMed1992

[Experimental study of hepatic inflow occlusion in extrahepatic obstructive jaundice--effects on systemic and hepatic hemodynamics and oxygen metabolism].

The effect of clamping both the hepatic artery and portal vein for 20 min in extrahepatic obstructive jaundice on systemic and hepatic hemodynamics and oxygen metabolism were studied in dogs, and the following results was obtained. 1) Dogs with obstructive jaundice were in a hyperdynamic state before hepatic inflow occlusion, showing an increased demand for oxygen in the liver. 2) After declamping, cardiac index and systemic oxygen delivery were decreased in normal dogs, but a further decrease was found in dogs with jaundice. 3) After declamping, hepatic arterial blood flow was increased in normal dogs. Portal blood flow was decreased just after declamping, but was soon restored. In dogs with jaundice, hepatic arterial blood flow increased to a lesser extent, and recovery of portal blood flow was delayed. 4) Hepatic oxygen consumption and oxygen extraction ratio were already increased markedly just after declamping in normal dogs, whereas the degree of the increase in these parameters was much smaller in dogs with jaundice. Thus, hepatic inflow occlusion in extrahepatic obstructive jaundice induces evident disorder of hepatic oxygen metabolism, and is suggested to be dangerous.

Animals↗
PubMed1990

Enhanced production of endogenous prostaglandin in obstructive jaundiced pancreas in dogs.

Endogenous pancreatic prostaglandin production in control and obstructive jaundice was investigated using isolated and perfused dog pancreas. In both groups, spontaneous production of prostaglandin E2 and prostaglandin I2 was recorded, and the levels did not change in both groups. The production of both prostaglandins in jaundice, however, was higher than that in the control on stimulation by 8 x 10(-11) mol of cholecystokinin-octapeptide. Amylase release with cholecystokinin-octapeptide at an amount of 8 x 10(-11) mol in jaundice was higher than in the control. The amylase release in both groups, however, showed further elevation on indomethacin pretreatment. On incubation of pancreatic dispersed cells in both groups, prostaglandin production in jaundiced cells was higher than that in control cells. These data showed that enhanced endogenous prostaglandin in obstructive jaundice might be caused by the characteristic change of pancreatic cells, which increased susceptibility to cholecystokinin-octapeptide because of long-term exposure to abnormal blood components, and enhanced prostaglandins might act as a cytoprotector of acinar cells in the pancreas damaged by cholecystokinin-octapeptide administration.

6-Ketoprostaglandin F1 alpha↗
PubMed1999

Somatostatin: possible cause of bacterial translocation in obstructive jaundiced rats.

The purpose of this study was to examine the effect of endogenous somatostatin hormone on bacterial translocation in obstructive jaundiced rats. Five groups of rats were studied: group I (n = 10), non-operated group (control); group II (n = 10), sham-operated group which underwent laparotomy and dissection of portal elements, while the common bile duct was not ligated and somatostatin was not injected; group III (n = 10), same as group II, plus injection of somatostatin; group IV (n = 10), common bile duct was ligated with laparotomy but somatostatin was not injected; group V (n = 10), same as group IV, plus somatostatin injection. The blood was analyzed for somatostatin, alkaline phosphatase, and bilirubin levels on the third and tenth days in all animals. At study termination (tenth day), peritoneal swab and blood cultures were taken, and liver, spleen, lung, and mesenteric lymph nodes were harvested for microbiological studies. Bacterial translocation levels were higher in groups III, IV, and V when compared with levels in groups I and II. Similar translocation levels were obtained when blood somatostatin levels were comparable. However, the highest translocation rate was found in groups IV and V in which the blood somatostatin level was also higher when compared with that in other groups. This finding shows that blood somatostatin level is increased in obstructive jaundice. This may explain the bacterial translocation and related sepsis found in obstructive jaundice.

Alkaline Phosphatase↗
PubMed1978

Lecithin--cholesterol acyltransferase and the lipoprotein abnormalities of obstructive jaundice.

1. We have studied the plasma lipoprotein abnormalities in obstructive jaundice to test the hypothesis that the abnormalities would correlate with plasma lecithin--cholesterol acyltransferase activity. 2. Very-low-density lipoproteins (VLDL) were normal in composition and had a normal pre-beta electrophoretic mobility when lecithin--cholesterol acyltransferase activity was high. When it was low VLDL had abnormal composition and ran in the beta position. 3. With high lecithin--cholesterol acyltransferase activity, low-density lipoprotein (LDL) was normal and cholestatic LDL (LP-X) was not found. With low lecithin--cholesterol acyltransferase activity up to three LDL fractions were found: (i) large triglyceride-rich particles, (ii) LP-X and (iii) a triglyceride-rich cholesteryl ester-poor particle of normal dimensions. 4. High-density lipoprotein (HDL) concentrations correlated with lecithin--cholesterol acyltransferase activity and HDL were normal in composition and electron-microscopic appearance when the activity was high. When lecithin--cholesterol acyltransferase activity was low HDL was abnormal in composition and 'stacked discs' were seen on electron microscopy as well as normal spherical particles. 5. These results suggest that low lecithin-cholesterol acyltransferase activity may cause at least some of the lipoprotein changes of obstructive jaundice.

Adult↗
PubMed2005

[Efficacy of transcutaneous endobiliary procedures in patients with obstructive jaundice].

Transcutaneous endobiliary procedures (TEP) were performed in 378 patients with obstructive jaundice (OJ). External decompression of the biliary ducts was carried out as the first stage of treatment in all the patients with OJ of various etiology. This procedure led to reduction of cholangitis symptoms and hepatic failure, improvement of general condition of the patients before radical surgery. Endoprosthesis of the bile ducts made in 121 patients allowed physiological passage of bile into the intestine and improved quality of life especially in inoperable patients with hepatic and pancreatoduodenal tumors. During external drainage in 27 (7.1%) patients dislocation of drainage of the common bile duct occurred. Postoperative lethality was 8.5%. After open surgeries 2 (1.2%) patients died.

Adult↗
PubMedDate not supplied

An uncommon complication of liver biopsy: obstructive jaundice from blood clots.

INTRODUCTION: The AA. report on a case of one young woman who developed obstructive jaundice induced by hemobilia after percutaneous liver biopsy, successfully treated with endoscopic retrograde cholangiopancreatography (ERCP) METHODS: An endoscopic sphincterotomy was performed with extraction of the clots OBSERVATIONS: Four weeks after ERCP the patient was healthy and asymptomatic, valuated as outpatient CONCLUSIONS: The role of ERCP in managing biliary sequelae of hemobilia is well established: biliary decompression is required if and intrabiliary lot causes obstructive jaundice and/or biliary colic. ERCP is feasible and leads to relief of symptoms in most cases, without the need of surgery.

Adult↗
PubMedDate not supplied

Magnetic resonance cholangiopancreatography in obstructive jaundice.

GOALS: To determine the ability of magnetic resonance cholangiopancreatography (MRCP) to diagnose the level and cause of obstruction in patients with obstructive jaundice. BACKGROUND: The limitations of available imaging modalities have led to the increasing use of MRCP, which is a noninvasive and highly accurate technique in evaluating patients with biliary obstruction. STUDY: Thirty patients were included in this study. MRCP was done using a fat suppressed, heavily T2 weighted fast spin echo sequence. The MRCP findings were confirmed on surgical exploration or clinical follow-up. RESULTS: MRCP could correctly identify ductal dilatation and the level of obstruction in all cases, except one. All causes of obstruction, except three, were detected. It failed to detect a common bile duct calculus in a minimally dilated ductal system and misdiagnosed a case of focal chronic pancreatitis as carcinoma head pancreas and a small pancreatic head mass as cholangiocarcinoma. It had a sensitivity of 94.44%, specificity of 81.81%, positive predictive value of 89.47%, and negative predictive value of 90% for the detection of malignant causes. The overall diagnostic accuracy for detection of level and cause of obstruction was 96.3% and 89.65%, respectively. CONCLUSION: The high diagnostic accuracy of MRCP in evaluating patients with obstructive jaundice indicates that it has the potential to become the diagnostic modality of choice in such patients.

Adult↗
PubMed1985

Antipyrine elimination in patients with obstructive jaundice: a predictor of outcome.

A number of factors are known to be related to increased mortality of surgery in obstructive jaundice, yet precise identification of patients at greatest risk is difficult. We have studied the elimination of the minor analgesic antipyrine as a dynamic measure of hepatic metabolic function in patients with obstructive jaundice undergoing percutaneous transhepatic biliary drainage. Of 46 patients in whom antipyrine clearance was measured, 21 had an antipyrine half-life less than 15 hours and 2 died in the hospital. Of 25 who had an antipyrine half-life greater than 15 hours, 10 died in the hospital, 4 before undergoing surgery. The difference in mortality is significant (p less than 0.05). Of 15 patients who had serial antipyrine tests, only 4 showed an improvement during percutaneous transhepatic biliary drainage. The antipyrine test may be a useful predictor of outcome in obstructive jaundice, and this study suggests that hepatic function does not improve in all patients undergoing preoperative percutaneous transhepatic biliary drainage.

Adult↗
PubMed2003

Surgical intervention for obstructive jaundice due to biliary tumor thrombus in hepatocellular carcinoma.

This retrospective study in eight surgically treated patients with obstructive jaundice due to biliary tumor thrombus in a patient with hepatocellular carcinoma (HCC) was performed to evaluate the role of surgical intervention. All biliary tumor thrombi were confirmed preoperatively or intraoperatively. Only two manifested intraluminal biliary obstructions due to a primary tumor that had not been found preoperatively. The operative procedures included hepatectomy with removal of the biliary tumor thrombus (n=3), hepatectomy combined with extrahepatic bile duct resection (n=1), thrombectomy through a choledochotomy (n=3), and piggyback orthotopic liver transplantation (n=1). The 1- and 3-year survival rates were 62.5% and 37.5%, respectively. Two patients survived more than 5 years. Surgical intervention was effective in patients with obstructive jaundice due to a biliary tumor thrombus in an HCC. Thus surgery for a recurrence can prolong survival, and liver transplantation is a treatment worthy of further investigation.

Adult↗
PubMed2006

Myeloid sarcoma of the extrahepatic bile ducts presenting as obstructive jaundice.

We report a rare case of myeloid sarcoma (MS) of the extrahepatic bile ducts presenting as obstructive jaundice in a patient without leukemia at time of diagnosis. A 75-year-old female presented with a one-month history of abdominal pain and jaundice. Computerized tomography scan of the abdomen showed stenosis of the extrahepatic bile ducts. Endoscopic retrograde cholangiography disclosed an irregular narrowing of the common biliary duct, suggestive of a cholangiocarcinoma, and resection was performed. Histologic examination showed diffuse transmural infiltration of malignant cells. These cells exhibited medium-sized round nuclei with central nucleoli and eosinophilic cytoplasm, and were strongly positive for myeloperoxidase, CD68, lysozyme, CD45, CD117 (c-kit protein) and CD43. Eight months following surgery the patient presented with multiple cutaneous nodules and bone marrow trephine biopsy showed acute myelomonocytic leukemia. A literature search identified two previously reported cases of MS of the extrahepatic biliary duct. MS should be taken into consideration in the differential diagnosis of a patient with obstructive jaundice. Immunohistochemistry is essential for a correct diagnosis.

Aged↗
PubMed1996

Insulin metabolism after relief of obstructive jaundice: intravenous glucose tolerance test with portal blood sampling.

BACKGROUND: Glucose intolerance and impaired insulin secretion are often associated with obstructive jaundice. Our objective was to determine whether such abnormalities would be ameliorated after jaundice was relieved by biliary drainage. METHODS: Twenty-four patients with hepatobiliary malignancy prospectively underwent intravenous glucose tolerance test with femoral and portal blood sampling, and the kinetics of insulin release were determined. Sixteen patients had obstructive jaundice (group A) that had been completely relieved by percutaneous transhepatic biliary drainage by the time of intravenous glucose tolerance testing, and eight patients exhibited no jaundice (group B). RESULTS: Integrated immunoreactive insulin (sigmaIRI, 10 muU min/ml; mean +/- SD) and integrated C-peptide (sigmaCPR, 10 ng min/ml) in the portal blood in group A were significantly lower than those values in group B (sigmaIRI: group A, 436.0 +/- 260.6; group B, 714.3 +/-287.2; p< 0.01; sigmaCPR; group A, 26 +/- 10.1; group B 49.5 +/- 18.8; p<0.005). The hepatic insulin extraction ratio (portal-femoral difference of sigmaIRI divided by portal sigmaIRI) in group A was significantly higher than that in group B (group A, 0.75 +/- 0.06; group B, 0.55 +/- 0.05; p<0.001), whereas the hepatic CPR extraction ratio did not differ significantly between the two groups (group A, 0.37 +/- 0.10; group B, 0.39 +/- 0.05). CONCLUSIONS: The impaired insulin secretion caused by obstructive jaundice is not fully reversed after percutaneous transhepatic biliary drainage. The high hepatic extraction ratio of insulin in patients who had been treated with percutaneous transhepatic biliary drainage may compensate for the impaired insulin secretion, although its mechanism is still unclear.

Adult↗