CLINICO-ETIOLOGIC PROFILE OF PATIENTS UNDERGOING ERCP FOR OBSTRUCTIVE JAUNDICE SECONDARY TO MALIGNANCY.

2021 ◽  
pp. 50-51
Author(s):  
Pawadshettar Shivakumar ◽  
Kani Shaikh Mohamed
Keyword(s):  
Obstructive Jaundice ◽  
Standard Of Care ◽  
Stone Disease ◽  
Palliative Surgery ◽  
Periampullary Carcinoma ◽  
Plastic Stent ◽  
Male Predominance ◽  
Medical College ◽  
Digestive Health ◽  
Head Of Pancreas

Background: Astudy describing the ERCPprole of the patients undergoing the procedure for malignancy related obstructive jaundice. Aim:To analyse the patients undergoing ERCPfor malignant etiology of obstructive jaundice and characterise the outcomes. Introduction: The etiology of obstructive jaundice can be delineated easily into malignancy vs benign etiology. Benign etiology is dominated by stone disease. Malignancy can be varying from periampullary carcinoma, carcinoma head of pancreas, duodenal tumours, cholangiocarcinoma and others. In this study we attempt to analyse the patient prole and outcomes undergoing the procedure at our centre. Methods: A retrospective observational study, conducted in the Department of Digestive Health and Diseases, Kilpauk Medical College, from September 2018 to July 1st, 2019. All the patients undergoing ERCP for obstructive jaundice with probable malignant etiology diagnosed basing imaging and histopathology modes were included. The demographics and the procedure events were recorded after having obtained the informed consent. Results: A total of 70 patients were included in the study. There was male predominance in the study with 48(74.2%) patients and females comprising 18(25.8%). Atotal of 10(14.2%) patients were below the age of 45yrs and 60(85.17%) were above 45 yrs. The predominant etiology for which patients underwent the procedure was cholangiocarcinoma(n= 34, 48.5%). Sixteen patients (22.8%) had periampullary growth, whereas 10(14.2%) had carcinoma head of pancreas, followed by 4 patients with carcinoma of the gall bladder. 24 (34.2%) patients needed a sphincterotomy, 42(60%) patients could be successfully cannulated. During cannulation 36(51%) could be cannulated with 3 or less attempts whereas rest needed >3. Amongst the cannulated patients a plastic stent was successfully placed. 18(25.7%) needed a dilator (SBDC) for successful deployment. A total of 14 patients developed complications of which 10(14.2%) patients developed bleeding during the procedure for which standard of care followed and 2 developed mild post ERCPpancreatitis which was duly managed. Conclusion:Although ERCPhas been established as standard of care for relieving jaundice with obstruction, technical difculties pertaining to the growth location and access for the same restrict the outcomes in many cases. Hence the availability of other modes including palliative surgery could also be offered in such subset of patients.

scholarly journals Extra-Hepatic Biliary Obstruction - A Cross-Sectional Study to Assess the Various Benign and Malignant Causes for Obstructive Jaundice among Patients Attending Trivandrum Medical College

2021 ◽  
Vol 10 (9) ◽  
pp. 600-603
Author(s):  
Swasthik K.S. ◽  
Preetha Sundaresan ◽  
Varun Vijayan
Keyword(s):  
Bile Duct ◽  
Obstructive Jaundice ◽  
Biliary Obstruction ◽  
Cross Sectional Study ◽  
Periampullary Carcinoma ◽  
Sectional Study ◽  
Cross Sectional ◽  
Malignant Obstruction ◽  
Study Results ◽  
Head Of Pancreas

BACKGROUND Extra-hepatic biliary tract obstruction can be due to a number of conditions. Most causes are due to stones in the common biliary duct or due to malignant obstruction. Malignant causes include carcinoma head of pancreas, periampullary carcinoma and cholangiocarcinoma. Besides calculus and malignant obstruction, benign and malignant strictures can also cause obstruction of extra hepatic biliary ducts. The objectives of the study were to describe the clinical profile of patients presenting with extra-hepatic biliary obstruction and to assess the known aetiological factors. METHODS The research was designed as a hospital based cross-sectional study in the general surgery wards of our institution from 2016 to 2017. All individuals who were diagnosed to have extra-hepatic biliary obstruction by imaging were included in the study. RESULTS Among the 66 cases studied, majority were due to malignancies and gall stones. The malignancies included carcinoma head of pancreas, periampullary carcinoma, cholangiocarcinoma and Klatskin’s tumour. Miscellaneous causes were bile duct stricture, cholelithiasis with biliary sludge and annular pancreas. For the malignant cases, Whipple surgery and its pylorus-preserving variant were the most common surgical procedures carried out. Biliary bypass procedures were also carried out in some patients. For patients with common bile duct (CBD) stones, cholecystectomy, choledocholithotomy and choledochojejunostomy were done. CONCLUSIONS Malignant causes of jaundice are more common than benign causes. Secondary stones are the commonest cause of non-malignant biliary obstruction. Jaundice is more severe and associated with pruritis and more intolerable and persistent in malignancy. Surgical bypass procedures give good palliation for obstructive jaundice. KEY WORDS Bile Ducts, Choledocholithiasis, Cholestasis, Extra Hepatic, Pancreatic Cancer, Periampullary Cancer

Surgical Bypass is Still Relevant in the Palliation of Malignant Obstructive Jaundice

2002 ◽  
Vol 32 (4) ◽  
pp. 216-219 ◽  
Author(s):  
Dhananjaya Sharma ◽  
Manish Bhansali ◽  
V K Raina
Keyword(s):  
Obstructive Jaundice ◽  
Exploratory Laparotomy ◽  
Palliative Surgery ◽  
Government Medical College ◽  
Malignant Tumours ◽  
Malignant Obstructive Jaundice ◽  
Endoscopic Techniques ◽  
Medical College ◽  
Surgical Bypass

Malignant tumours of the biliopancreatic system causing obstructive jaundice are not curable in most of the patients, and palliation plays a very important therapeutic role. The role of surgery in palliation of malignant obstructive jaundice has been questioned in the light of availability of endoscopic techniques. In developing countries, however, exploratory laparotomy and palliative surgery (when possible) is the only option available as sophisticated instruments and the expertise to use them is limited to a very few centres. This was a retrospective study of 83 consecutive cases with malignant obstructive jaundice admitted to the Department of Surgery, NSCB Government Medical College, Jabalpur, MP, India from January 1996 to December 2000.

scholarly journals The Current Standard of Care in the Periprocedural Management of the Patient with Obstructive Jaundice

2006 ◽  
Vol 88 (7) ◽  
pp. 610-616 ◽  
Author(s):  
DL Clarke ◽  
Y Pillay ◽  
F Anderson ◽  
SR Thomson
Keyword(s):  
Obstructive Jaundice ◽  
Standard Of Care ◽  
Optimal Management ◽  
Current Standard ◽  
Periprocedural Management

This review provides a literature-based guide to the optimal management of the patient with obstructive jaundice with emphasis placed on prevention of complications.

scholarly journals Clinical spectrum of obstructive jaundice: a descriptive crosssectional study

2021 ◽  
Vol 6 (1) ◽  
pp. 53-57
Author(s):  
R. Naveena MS
Keyword(s):  
Obstructive Jaundice ◽  
The Elderly ◽  
Stone Disease ◽  
Clinical Spectrum ◽  
Bile Duct Stricture ◽  
Elderly Male ◽  
Male Population ◽  
Pancreas Head ◽  
Duodenal Carcinoma ◽  
Duct Stricture

Objective. The objective of this study was to evaluate the clinical spectrum of obstructive jaundice in inflammation, stone disease, and malignancy. Methods. A descriptive observational study was done among 50 patients with the diagnosis of obstructive jaundice during the period 2012 to 2013. A detailed history and clinical examinations and radiological confirmation were done. Results. Among the participants, 74% participants had jaundice, 58% with vomiting as presenting complaints. Among benign cases, 60% were choledocholithiasis, 25% were common bile duct stricture, and 15% were choledochal cyst. Among malignant cases, 26.67% were periampullary carcinoma, 23.33% had carcinoma of the pancreas head, and 13.33% had D2 duodenal carcinoma. Conclusions. The etiology of obstructive jaundice was malignancy in the elderly male population. The most common presenting features were yellowish discoloration of skin and mucosa followed by vomiting and abdominal pain.

scholarly journals Candida and Enterobacter co-infection in a case of periampullary carcinoma with obstructive jaundice

2015 ◽  
pp. 1801-1802
Author(s):  
Sunita Toleti ◽  
Manisegaran Manivasagan ◽  
Sumana Prudhve ◽  
Tapasya Raavi ◽  
Naseema Shaik ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Periampullary Carcinoma

scholarly journals Prevalence of Sub-Clinical Hypothyroidism in Diagnosed Cases of Gallstone Disease

2021 ◽  
pp. 207-212
Author(s):  
C. Kamalakkhannan
Keyword(s):  
Gallstone Disease ◽  
Gall Stone ◽  
Clinical History ◽  
Gallstone Formation ◽  
Stone Disease ◽  
Thyroid Function Tests ◽  
Age Group ◽  
Medical College ◽  
Gall Stone Disease ◽  
A Prospective Study

Thyroid issues have long been debated as a possible cause of gall stone disease. The link between hypothyroidism and gallstone disease could be explained in a variety of ways. The main objective of this study is to determine the prevalence of hypothyroidism in gallstone patients and to rule out hypothyroidism as a probable cause of gallstone formation. A prospective study was conducted in surgical wards of Department of surgery sree balaji medical college from 2016 to 2017. All patients were evaluated using a comprehensive clinical history and examination, as well as suitable investigations such as abdominal USG, thyroid function tests, and lipid profiles. Out of 22 patients 19 patients (86.4%) had normal TSH, 2 patients (9.1%) had increased TSH, 1 patient (4.5%) had decreased TSH. Raised TSH was more in the AGE Group of 61- 75 years, which is comparable to other studies. Out of 22 patients, (100%) had normal T3 levels. 19 patients (86.4%) had normal T4 levels and Ultrasound examination of neck, 2 patients (9.1%) had decreased T4 level and 1 patient (4.5%) had increased T4 levels and 3 patients (13.6%) had abnormal Ultrasound Neck findings. Hence In this Study Cholelithiasis is most commonly seen in Females of age group of 41-60 years and prevalence of raised TSH level in cholelithiasis patient was 9% and most were found in the age group of 61-80 years.

scholarly journals Health Problems Among Forcibly Displaced Myanmar Nationals (FDMNs) Admitted To The Medicine Ward of Cox’s Bazar Medical College Hospital

2021 ◽  
Author(s):  
Mohammad Ismail ◽  
Mohammad Farhad Hussain ◽  
Mohammad Abdullah Al Hasan ◽  
AHM Mustafa Kamal ◽  
Monjur Rahman ◽  
...  
Keyword(s):  
Gastrointestinal Disease ◽  
Health Problems ◽  
Medical College Hospital ◽  
Vulnerable Groups ◽  
College Hospital ◽  
Case Record ◽  
Male Predominance ◽  
Medical College ◽  
Coronary Syndrome ◽  
Snake Bites

Abstract Background Forcibly displaced Myanmar nationals (FDMNs) or Rohingya refugees are one of the vulnerable groups suffering from different kinds of health problems but have been less reported yet. Therefore, the study was designed to delineate the health problems among FDMNs admitted to Cox’s Bazar Medical College Hospital. Methods This hospital-based cross-sectional study was conducted at the Medicine ward, Cox’s Bazar Medical College Hospital, for a six-month period following approval. Rohingya refugees who were admitted during the study period were approached for inclusion. Informed written consent was ensured prior to participation. A structured questionnaire was used during data collection. Collected information was recorded in case record form. A total of 290 subjects were interviewed. Analysis was performed using the statistical package for social science (SPSS) version 20. Results The mean age of the participants was 48.76±18.67 years (range: 16-91), with a clear male predominance (60.7%). Family size ranged 6-8. All of the participants reported at least one of the illnesses. Of all, 29.66% patients reported disease of the respiratory system, and 26.9% reported disease of the gastrointestinal disease and hepatobiliary system. Accidental injury or injury due to electrocution or thin falls or snake bites was present in 10.4% of the cases. Among the single most common diseases, COPD (20%) was the most frequently observed, and the rest of them were chronic liver disease (13.1%), pulmonary TB (5.5%), ischemic stroke (5.5%), CAP (4.1%), acute coronary syndrome (3.4%), thalassaemia (3.4%) and hepatocellular carcinoma (3.4%). Among the top 6 reported diseases, PTB was more common in elderly individuals (p=0.29). The disease pattern was similar across the sexes among the refugees except community acquisition pneumonia (CAP), which was commonly observed among males (p=.004). Considering different age groups, genitourinary problems were more common in males aged >60 years, and rheumatology and musculoskeletal problems were equally affected in females aged between 40-60 years. Conclusion COPD, CLD and CAP were the most prevalent diseases in FDMN patients who attended the medicine ward of Cox’s Bazar Medical College Hospital. Further exploration is warranted before any policy making and comprehensive plan.

scholarly journals Management of Symptomatic Renal Cysts by Laparoscopy: Our Initial Experience

2020 ◽  
Vol 21 (2) ◽  
pp. 137-139
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
AKM Shahadat Hossain ◽  
Rifat Zaman ◽  
Prodyut Kumar Saha ◽  
Hafiz Al Asad ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Renal Cysts ◽  
Standard Of Care ◽  
Drain Tube ◽  
College Hospital ◽  
Medical College ◽  
Cyst Recurrence ◽  
The Mean

Introduction and objective: Over the last decade laparoscopic surgery has been popularized and developed to such an extent that it can be considered gold standard for many types of procedures in urology. Currently the majority of operations in urologic field can be performed by laparoscopy. This is because it is as effective as open surgery, but associated with less postoperative pain, shorter hospital stay, faster recovery and has better cosmetic result. The aim of the study is to evaluate the results of our experience of treating symptomatic renal cysts by laparoscopy. Materials and methods: This prospective study was conducted from January 2015 to December 2017 in the Department of Urology in a single unit of Dhaka Medical College Hospital. All the patients were admitted through out-patient department. Among them those who fulfilled the criteria were selected for laparoscopic surgery. All patients were diagnosed by ultrasonography and computed tomography to determine the Bosniak classification of the cyst & informed written consent was taken. Total five laparoscopic decortication of renal cysts were performed and the results of our experience were compared with data from published article. Pain and cyst recurrence were assessed during the follow-up. Results: Our study described the results of 05 laparoscopic decortication of renal cysts. All procedures were completed successfully by transperitoneal approach, with no major intraoperative and postoperative complications. There was a placement of drain tube in one patient. The mean (range) operative duration was 68 (40–110) min, affected by the site and number of cysts decorticated. The mean post operative hospital stay was 1.8 (1- 3) days. All patients were symptom-free and no sign of recurrence during the follow-up. Conclusion: Laparoscopic decortication of symptomatic renal cysts should be the standard of care and it is feasible with conventional laparoscopic instruments and gives a better cosmetic outcome. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.137-139

scholarly journals HISTOPATHOLOGICAL STUDY OF BONE LESIONS AT DARBHANGA MEDICAL COLLEGE, LAHERIASARAI, BIHAR.

2021 ◽  
pp. 1-3
Author(s):  
Ragini Kumari ◽  
Kunal Shankar ◽  
Ajit Kumar Chaudhary ◽  
Debarshi Jana
Keyword(s):  
Bone Tumors ◽  
Bone Biopsy ◽  
Correct Diagnosis ◽  
Benign Tumors ◽  
Bone Lesions ◽  
Histopathological Study ◽  
Histopathological Diagnosis ◽  
Male Predominance ◽  
Medical College ◽  
Neoplastic Lesions

Background: A spectrum of pathological bone lesions can be presented in any form from inflammatory to neoplastic conditions. Diagnosis of all bone lesions is made by radiological modalities like plain X-ray, CT scan, MRI and bone scintigraphy. Aim and Objectives: To study histopathological features of bone lesions and correlate them with age, site and type of lesions. Material and Methods: The study was carried out at Department of Pathology associated with Orthopaedics, Darbhanga Medical College, Lahertiasarai, Bihar from April 2020 to November 2020. A total of 102 bone lesions were analyzed. Bone biopsy was performed after detailed clinical and radiological examination. After fixation, decalcification, processing and H&E staining, histopathological diagnosis was made. Results: Out of all 102 cases, 44.11% bone lesions were found between 25-50 years with male predominance. The incidence of non neoplastic lesions was 74.5% and neoplastic lesions were 25.4%. Amongst neoplastic lesions, incidence of benign tumors was 17.64% and malignant tumors were 7.8%. The Tuberculous Osteomyelitis was most common non neoplstic lesion while giant cell tumor and osteochondroma were common among benign tumors and osteosarcoma and Secondary metastasis were common among malignant bone tumors. Conclusion: Though Bone tumors are less common, if viewed in perspective of clinico radiology and histopathology, correct diagnosis can be made.

Sign in / Sign up

Export Citation Format

Share Document