Obstructive Jaundice is an important surgical problem that occurs when there is an obstruction to the passage of conjugated bilirubin from liver
cells to intestine. It is among the most challenging conditions managed by general surgeons and results in high morbidity and mortality. Hence,
early diagnosis of the cause of obstruction is very important especially in malignant cases, as resection is only possible at an early stage. Signicant
3
advances have been made over the past 30 years in understanding pathophysiology, diagnosis and management of obstructive jaundice. Biliary
obstruction effects the bile ducts and leads to disturbed liver function and widespread systemic effects. Jaundice patients are at high risk for
developing hepatic and renal dysfunction, cardiovascular problems, nutritional deciencies, bleeding problems, infections, and wound
4
complications, and higher perioperative mortality. There is usually an overlap of features among different obstructive pathologies, for example
uctuating icterus is present in both common bile duct stone and periampullary carcinoma.
AIM:To study the clinical spectrum of the patient with malignant obstructive jaundice.
MATERIALS AND METHODS: The study has been carried out on 48 patients with clinical presentation of suspected malignant obstructive
jaundice over a period of 13 months who were seen in general surgery department of a tertiary care centre of Eastern India. A detailed history and
relevant information were collected from the patient and relatives like mode of onset, duration, progression, loss of weight and substance abuse.
Besides, information like place of residence, family history, personal history, drug intake etc. were recorded.
RESULTS: The mean age (mean ± s.d.) of the patients was 66.27±5.85 years with range 52 - 78 years and the median age was 67.0 years. 81.3%
of patients had signicant loss of weight which was signicant. 75.0% of patients had palpable mass abdomen and it was signicant. There was
neither any signicant association between habit of alcohol intake nor the habit of smoking with cancer of the patients.
CONCLUSION: The descriptive study on malignant obstructive jaundice patients demonstrated the various modes of presentation. Obstructive
jaundice is a multi spectrum disease, in terms of organ involvement, local spread and resectability. Analytical and experimental studies done for
each of the etiologies separately will throw more light on the possible evolution of early diagnosis and management.