Relation between the clinical presentation and etiology of obstructive jaundice

Abstract

Background: Obstructive jaundice encompass a wide range of diseases, its final management depend on the cause and the level of obstruction.Objective:To Clarify the relation between Age, gender, Symptoms of patient, Total Serum Bilirubin (TSB) level and serum Alkaline Phosphatase (ALP) level and the causes of obstructive jaundice (benign or malignant?).Patients and Methods: Retrospective study conducted in Baghdad teaching hospital covering three years period. The age, gender, symptoms of the patient, total serum bilirubin (TSB) and serum alkaline phosphatase (ALP) were evaluated as predictive factors for the underlying obstructing pathology. Results: 206 patients with obstructive jaundice were included .The ages ranged between 18 to 80 years. 108 males and 98 females male to female ratio 1.1:1 . malignant pathologies found in 52% of patients most of them above the age of 50 year. The mean level of TSB in malignant cases was 18 mg/dl while in benign group was 9.16 mg/dl. Conclusion: Male gender , age more than 50 year , weight loss and TSB level more than 10 mg /dl are factors associated with increased risk of malignant underlying pathology of obstructive jaundice , while the presence of pain and fever is suggestive of benign cause .The level of ALP cannot be used as a predictive factor for the cause of the obstructive jaundice.