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.

SourceResearch connectionFrom yearThrough year

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

At least 1,027 records · Page 57Linked to original sources

PubMed1992

Obstructive jaundice associated with polysplenia syndrome in an older child.

Polysplenia syndrome includes malrotation and various forms of heterotaxy. Associated with this and malrotation are extrahepatic biliary anomalies. Actual obstruction, other than in associated biliary atresia, is extremely rare, and rarer still in older children. An 11-year-old girl presented with obstructive jaundice, malrotation, and heterotaxy, which were found in association with common bile duct anomalies and intermittent common bile duct obstruction. This case illustrates that the differential diagnosis of obstructive jaundice, even in older children, should include congenital anomalies, and that biliary anomalies should be considered in cases of malrotation and heterotaxy.

Abnormalities, Multiple↗

PubMed2005

Pseudohyponatraemia in a patient with obstructive jaundice.

INTRODUCTION: Pseudohyponatraemia is uncommonly associated with severe hypercholesterolaemia. Severe hypercholesterolaemia encountered in obstructive jaundice due to an abnormal lipoprotein, lipoprotein X (LpX), may result in pseudohyponatraemia. CASE REPORT: We report a case of falsely low sodium measurements in a patient with severe hypercholesterolaemia due to obstructive liver disease. The pathophysiology, complications and analytical effects of LpX are briefly discussed. CONCLUSION: The possibility of pseudohyponatraemia should be considered in severely hypercholesterolaemic samples.

Adult↗

PubMed2002

Obstructive jaundice in hepatocellular carcinoma: response after percutaneous transhepatic biliary drainage and prognostic factors.

PURPOSE: To evaluate the therapeutic effect of percutaneous transhepatic biliary drainage (PTBD) in patients with obstructive jaundice caused by biliary involvement of hepatocellular carcinomas (HCC) and to determine the prognostic factors. METHODS: We retrospectively analyzed the data of 22 consecutive patients (M:F = 20:2, mean age 52.8 years). Inclusion criteria were the patient having obstructive jaundice caused by HCC that invaded the bile ducts and having at least 4 weeks of follow-up data after the PTBD. We defined "good response" and "poor response" as whether the level of total bilirubin decreased more than 50% in 4 weeks or not. Total bilirubin level (T-bil), Child-Pugh score and the location of biliary obstruction for the two groups were compared. In addition, the interval between clinical onset of jaundice and PTBD, the degree of parenchymal atrophy and the size of the primary tumor were compared. RESULTS: Of the 22 patients, 13 (59.1%) showed good response. T-bil was significantly lower in the good response group than in the poor (14.2 +/- 6 mg/dl vs 25.9 +/- 13.8 mg/dl, p =.017). In the five patients with T-bil <10 mg/dl, four (80%) showed good response, while in nine patients with T-bil > 20 mg/dl, only three (33%) showed good response. Although statistically not significant, patients with Child score <10 showed better results [good response rate of 66.7% (12/18)] than patients with Child score > or = 10 [good response rate of 25% (1/4)]. Involvement of secondary confluence of the bile duct also served as a poor prognostic factor (p = 0.235). The interval between clinical onset of jaundice and PTBD, the presence of parenchymal atrophy and the size of the tumor did not show significant effect. CONCLUSION: Early and effective biliary drainage might be necessary in this group of patients with limited hepatic function.

Carcinoma, Hepatocellular↗

PubMed1997

Activity of class I and II isoenzymes of alcohol dehydrogenase measured by a fluorometric method in the sera of patients with obstructive jaundice.

Using new fluorogenic substrates, we measured the activity of class I and II alcohol dehydrogenase (ADH) isoenzymes in the sera of patients with obstructive jaundice. The activity of class I isoenzymes was elevated two-fold, whereas that of class II isoenzymes was unchanged. This increase of class I isoenzymes explains low increase of total serum ADH activity. ADH isoenzymes and total enzyme activities correlated better with aminotransferases, than with alkaline phosphatase and gamma-glutamyltransferase, but we can conclude that class I ADH isoenzymes measured with fluorogenic substrates are indicative of obstructive jaundice.

Adult↗

PubMed1989

[Acute peptic lesions of the gastroduodenal mucosa in patients with obstructive jaundice].

Complex study of the gastric acid-producing activity, the condition of the gastroduodenal mucosa, and the serum gastrin concentration in 80 patients with obstructive jaundice showed that the appearance of acute erosive-ulcerative injuries of the mucosa of the gastroduodenal zone depended on the increase of activity of the peptic factor of the gastric medium. Peptic complications occurred in 27.1% of patients with initial normo and hyperacidity and a high level of blood gastrin. The absence of bile in the duodenum (obstructive jaundice, by-pass biliodigestive anastomoses) stimulated the peptic factor. This is evidently linked with secretin deficiency (absence of the effect of bile on the secretin producing S-cells) leading to weakened inhibiting effect of secretin on the serum gastrin content, which results in hypergastrinemia and hyperacidity.

Acute Disease↗

PubMed1994

Palliative surgical treatment of malignant obstructive jaundice.

One-hundred-and-forty-five cases of malignant obstructive jaundice were seen from January 1989-December 1992. Carcinoma gallbladder (74/145) and carcinoma pancreas (67/145) were the two common causes. Fifty patients underwent a palliative surgical biliary bypass procedure. Jaundice was present in all the patients. Pruritus (40/50), cholangitis (17/50) and gastric outlet obstruction (11/50) were the other predominant symptoms which required palliation. Surgical palliation was achieved with a morbidity and mortality of 38% and 8%, respectively. Jaundice, pruritus and cholangitis were relieved in 92%, 88% and 88%, respectively. All patients with gastric outlet obstruction had complete relief. The mean hospital stay was 18.5 days. The mean survival was 6.5 months and 8.6 months for carcinoma gallbladder and carcinoma pancreas, respectively.

Adult↗

PubMed2001

[Clinical study on the changes of growth hormone/insulin-like growth factor-I axis in patient with obstructive jaundice].

OBJECTIVE: To explore the changes and clinical significance of growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis in patient with obstructive jaundice (OJ). METHODS: The serum GH, GH binding protein (GHBP), IGF-I, endotoxin, prealbumin, and liver function of 60 male in- patients with OJ were investigated 1 day before operation and 1, 3, and 7 days after the operation. Forty male patients with simple gallbladder stone who were hospitalized during the same period as the 60 above mentioned patients, were chosen as controls. RESULTS: The levels of GH, GHBP and IGF-I in patients with obstructive jaundice were significantly lower (7.4 micrograms/L +/- 3.6 micrograms/L, 9.1 +/- 2.3 B/T* 100, and 49.8 mg/L +/- 6.6 mg/L respectively) than those in control group(13.9 micrograms/L +/- 5.7 micrograms/L, 13.3 +/- 1.6 B/T* 100, and 61.4 mg/L +/- 6.5 mg/L respectively, P < 0.01) and were correlated closely with the levels of bilirubin, prealbumin and endotoxin (P < 0.01). CONCLUSION: There is an obvious downregulation of GH-IGF-I axis in patients with OJ probably because of the expression inhibition resulting from dystrophy and endoxemia. It may be one of the important factors mediating the pathophysiological changes in OJ.

Adult↗

PubMed2005

Castleman disease presenting as obstructive jaundice.

A 48-year-old Saudi male was admitted with features of obstructive jaundice. Endoscopic retrograde cholangiopancreatography showed stricture in distal common bile duct CBD. Computed tomography scan revealed lymphadenopathy along CBD and in porta hepatis. Cholangiocarcinoma, lymphoma or metastatic deposits were suspected but no definite preoperative diagnosis could be established. Laparotomy disclosed lymph node enlargement in porta hepatis and along the CBD and lesser curvature of the stomach. Triple bypass procedure was performed to relieve the obstruction. Pathological examination of the lymph nodes showed Castleman disease of hyaline vascular type.

Castleman Disease↗

PubMed1987

An approach to the mechanism of acute ulceration in obstructive jaundice.

Changes of noradrenaline (NA) and prostaglandin (PG) E2 in gastric mucosa and gastric wall blood flow (GWBF) were investigated after stress load in rats with obstructive jaundice. We found that water immersion and restraint stress more easily increased the ulcer index and decreased GWBF, corresponding to a decrease of the NA and PGE2 contents in the gastric mucosa, as the duration of jaundice increased. Administration of PGE2 reduced the increase of the ulcer index and the decrease of the GWBF and NA contents in the gastric mucosa. It is suspected that the rapid decrease of NA and PGE2 is connected with the rapid decrease of GWBF after stress load in obstructive jaundice, and we reached the hypothesis that both PGE2 and NA mutually regulate local GWBF.

Acute Disease↗

PubMedDate not supplied

Hepatic artery aneurysm, an unusual cause of obstructive jaundice: MR cholangiography findings.

Hepatic artery aneurysms are rare vascular lesions, often with a nonspecific clinical presentation, and difficult to diagnose before rupture. We report the case of a patient with obstructive jaundice caused by a compression on the right biliary duct by a right hepatic artery aneurysm in which the diagnosis was suggested by magnetic resonance cholangiography and confirmed by Doppler sonography and preoperative digital subtraction angiography.

Aged↗

PubMed1991

[Obstructive jaundice in Yaounde. Value of echography and transhepatic cholangiography in determining the cause].

The purpose of the study was to assess the clinical value of ultrasonography (US) and percutaneous transhepatic cholangiography (PTC) in the workup of obstructive jaundice in Yaoundé. From 3,000 ultrasonographic studies done between September 1987 and February 1990, the authors drew 37 cases of obstructive jaundice. 22 of them were explored with both US and PTC. The cause of obstruction was tumor for 14, inflammation or malformation for 4 and biliary stone for 4. US could predict the cause in 55 p. cent of cases and PTC in 77 p. cent of cases. PTC was particularly helpful in case of non tumoral causes. The authors conclude that, in their setting where computed tomography is scarce and expensive, the combination of both US and PTC is rewarding, when the problem is the determination of the nature of obstruction.

Adult↗

PubMed1983

Metastatic melanoma presenting as obstructive jaundice with hemobilia.

Metastasis of melanoma to gastrointestinal organs are common and have been well documented. Metastasis to the common bile duct with a clinical presentation of obstructive jaundice and hemobilia, as encountered in our patient, is a heretofore unreported clinical problem. This diagnosis was not suspected before operation but was established after a successful pancreaticoduodenectomy. The patient had an uneventful recovery and has shown no signs of recurrence. The causes of obstructive jaundice and hemobilia have been presented and discussed.

Adult↗

PubMed2002

The bcl-2 mRNA expression in GCDC-induced obstructive jaundice in rats and its implication in hepatocellular apoptosis.

The modulatory role of bcl-2 gene in hepatocellular apoptosis of rats with glycochenodeoxycholate (GCDC)-induced obstructive jaundice was investigated. The hepatocytes in normal rats and those with bile duct-ligation for 7 days, 14 days and 21 days were isolated and obtained by in situ collagenase perfusion and primary culture. The expression of bcl-2 mRNA in the hepatocytes was detected by RT-PCR. Primary culture was performed on the hepatocytes from normal rats and those with bile duct-ligation for 14 days. 100 mumol/L GCDC was added to the hepatocytes for incubation for 24 h. The hepatocellular apoptotic ratio was measured by using FCM and hepatocellular apoptosis detected in situ by using TUNEL technique. Results showed that the expression of bcl-2 mRNA was not detectable in the hepatocytes of normal rats by RT-PCR technique, while detectable in the hepatocytes of those with bile duct ligation (BDL) for 7, 14 and 21 days. Hepatocellular apoptosis in the BDL group was obviously decreased as compared with normal control group after addition of 100 mumol/L GCDC to the cells for 24 h. It was concluded that the hepatocytes in the BDL rats expressed bcl-2. During obstructive jaundice, expression of bcl-2 from the hepatocytes can inhibit the bile salt-induced hepatocellular apoptosis.

Animals↗

PubMed1993

Monocyte secretion of beta-hexosaminidase in patients with obstructive jaundice.

Monocyte hydrolases are harmful when secreted inappropriately. In this study we have investigated the levels of one of the hydrolases. beta-hexosaminidase in patients with obstructive jaundice. These patients showed markedly elevated plasma levels, and their monocytes show increased spontaneous secretion and total enzyme content. The plasma enzyme levels correlate with monocyte enzyme content as well as bile salt, and bilirubin levels, the high levels may also reflect Kupffer cell damage, as these cells clear the enzyme. Compared with controls monocytes from jaundiced patients show reduced enzyme secretion after PMA stimulation, in vitro, and unchanged secretion after zymosan stimulation. There is a difference between plasma enzyme levels in benign and malignant patients but this does not provide a clear distinction between the two groups. We conclude that patients with obstructive jaundice have increased blood level of beta-hexosaminidase, and that activated monocytes partly contribute to this change.

Aged↗

PubMed1995

Failure of macrophage activation in experimental obstructive jaundice: association with bacterial translocation.

Bacterial translocation from the gastrointestinal tract and macrophage activation are central to current theories of sepsis. The relevance of both in obstructive jaundice is unclear. The effect of bile duct ligation for 7 days on bacterial translocation to mesenteric lymph nodes and on macrophage activation in a rat model was examined. Compared with an incidence of zero in sham-ligated controls, bile-duct ligated rats had a 67 per cent incidence of Gram-negative colonization of mesenteric lymph nodes. This was associated with a significant (P < 0.001) decrease in macrophage tumour necrosis factor, superoxide anion and nitric oxide production compared with that in sham controls. Spontaneous bacterial translocation occurs in experimental obstructive jaundice and is associated with marked suppression of macrophage activation. This suggests a mechanism whereby jaundiced patients may be more susceptible to persistent infection but relatively protected against uncontrolled sepsis.

Animals↗

PubMed2005

[Obstructive jaundice caused by portal varicosis].

In a 66-year-old woman with pruritus, jaundice, dark-brown urine and light-colored faeces obstructive jaundice was diagnosed. Despite extensive investigations, it was not possible to clearly distinguish if varicosis or cholangiocarcinoma was the cause of the obstruction. During laparotomy the right lobe of the liver was seen to be greatly underdeveloped. The portal system showed a varicose deformation with compression of the bile ducts and portal hypertension. The right lobe of the liver was removed and the portal hypertension was treated by creating a shunt between the hepatic portal vein and the right ovarian vein. The jaundice disappeared and the patient recovered. Histological investigation showed atrophy, secondary biliary fibrosis, cirrhosis and a biliary cystadenoma. There were no signs of malignancy. The varicose deformation can be considered to be a result of the portal hypertension caused by fibrosis and cirrhosis with possibly a history of thrombosis and insufficient recanalization.

Aged↗

PubMed1988

A decision tree for early differentiation between obstructive and non-obstructive jaundice.

We present a method for early differentiation between obstructive and non-obstructive jaundice. On the basis of 14 variables (clinical data and clinical chemical tests, all available within 48 h) a simple decision tree or flow chart has been constructed. The diagnostic yield was as follows: 857 of 982 consecutive jaundiced patients (87%) in a data base and 98 of 108 patients in an independent test sample (91%) were correctly classified. Decision trees for the differentiation between benign or malignant causes within the obstructive group and between acute or chronic causes within the non-obstructive group are also presented. The resulting four-way classification was correct for 77% of the patients in the data base and for 72% of the patients in the test sample. The decision trees are compared with previous methods founded on Bayes' rule and logistic discrimination. The decision trees enable a quick and reliable classification of jaundiced patients, thus providing a valid basis for rational planning of the further diagnostic study.

Cholestasis↗

PubMed1989

[Obstructive jaundice and advanced gastric carcinoma--correlation with its histopathology].

One hundred twenty-nine patients with far advanced or recurrent gastric carcinoma underwent computed tomography (CT) of the abdomen. There were three histologic types: differentiated (n = 41), undifferentiated (n = 68), and unclassified (n = 20). Eighteen patients who had developed obstructive jaundice were retrospectively studied to elucidate the nature of obstruction with histologic correlation. In differentiated carcinomas tumor tended to grow in an expansive fashion. A fairly large, well-defined lymph adenopathy was observed on CT. The extrahepatic bile duct surrounded by lymph nodes appeared as "doughnut sign" in six of eight patients. Undifferentiated gastric carcinoma had tendency to extend infiltratively. Bile duct obstruction was only a part of diffuse spreading. In spite of the presence of obstructive jaundice, no discrete mass was demonstrated around the extrahepatic bile duct on CT. In none of nine patients was present "doughnut sign". The significance of lymph node dissection along the extrahepatic bile duct in patients with differentiated gastric carcinoma was emphasized. The region of hepatoduodenal and pancreatico-duodenal lymph nodes should be carefully evaluated in interpretation of abdominal CT.

Carcinoma↗