What is obstructive jaundice? The causes of development and methods of treatment of this disease will be described below. You will also learn about the symptoms of this disease and how it is diagnosed.
Basic information
Obstructive jaundice is characterized by an increased content in the tissues of a substance such as bilirubin. This element gives the skin and mucous membranes a yellowish color.
Bilirubin is a bile pigment. According to experts, it has two fractions: direct, that is, bound, and indirect, that is, free.
Thus, obstructive jaundice is characterized by excessive accumulation of the mentioned element, which occurs as a result of complete or partial blockage of the lumen of the bile ducts. Another name for this disease is obstructive jaundice.
Main causes of disease development
Differential diagnosis of the causes of obstructive jaundice should be carried out only in a hospital setting. About what research methods are used, we will tell below.
In the normal state of the patient, the bile formed in the liver should, with a certain frequency,excreted in the duodenum in order to take a direct part in the process of digestion. However, in some cases this does not happen. The following reasons may be an obstacle to such a process:
- stenosis, or the so-called narrowing of the ducts, as well as swelling of the mucous membrane in the presence of cicatricial post-inflammatory strictures (for example, observed in cholangitis or cholecystitis) or tumor compression;
- mechanical obturation, or the so-called blocking of a certain section of the bile ducts by displaced calculi (stones) in the presence of gallstone disease.
All of the listed pathological phenomena lead to stagnation of bile (that is, to the formation of cholestasis), resulting in hypoxia, which damages hepatocytes.
It should also be noted that an abscess, a cyst of the gallbladder or pancreas, as well as parasites such as roundworms or echinococcus can become the cause of the development of obstructive jaundice.
Symptoms of disease
How is obstructive jaundice manifested? The symptoms of this disease are hard to miss. As a rule, such a disease develops acutely.
According to experts, jaundice is manifested by such signs as:
- nausea, fever, vomiting;
- excruciating stabbing pains in the right hypochondrium, which grow in waves and radiate to the right shoulder blade or collarbone;
- Discoloration of feces as bilirubin no longer entersintestines;
- excretion of bilirubin along with urine, which contributes to its staining in a dark brown color;
- severe itching of the skin due to the accumulation of toxic bile acids in the body.
Other signs of illness
How can you recognize the development of obstructive jaundice? Violation of the flow of bile of a chronic nature occurs in exactly the same way as described above. However, the severity of such symptoms may increase depending on the duration of cholestasis. Also, in some cases, patients experience steatorrhea (that is, undigested fat is found in the stool), skin hyperpigmentation, weight loss and xanthomas (that is, lipid deposits in the skin).
It should also be noted that timely differential diagnosis of obstructive jaundice can prevent the development of a disease such as cirrhosis. This disease is characterized by the formation of connective tissue fibrous nodes in the liver, which occur in response to necrosis of hepatocytes due to metabolic disorders and oxygen starvation.
With the development of jaundice in the human body, the metabolism of fat-soluble vitamins changes. In addition, a lack of vitamin D leads to osteoporosis (that is, increased bone fragility), as a result of which the patient feels discomfort in the spine (in the lumbar or thoracic region), and also suffers from spontaneous fractures.
It should also be said that obstructive jaundice often provokes the developmenthemorrhagic syndrome, which includes nosebleeds, the appearance of vascular "asterisks" and bruises on the skin. Such phenomena are a consequence of vitamin K deficiency.
With a lack of vitamin A in the body, the patient's ability to twilight vision is reduced. In addition, prolonged cholestasis greatly increases the likelihood of gallstone formation.
Also, against the background of the development of jaundice, the risk of infection and the occurrence of bacterial cholangitis, or the so-called inflammation of the bile ducts, increases. This condition usually presents with fever and pain in the upper right corner of the abdomen.
Methods for diagnosing obstructive jaundice
Now you know that obstructive jaundice is characterized by an increased content of bilirubin in the blood. However, a biochemical blood test for such a disease does not give a complete diagnostic picture. Therefore, many specialists conduct other laboratory tests, as well as use various instrumental methods.
So, for the diagnosis of obstructive jaundice it is necessary:
- do a complete blood count;
- undergo endoscopic retrograde or magnetic resonance cholangiopancreatography;
- undergo computed tomography and ultrasound of the abdominal organs;
- do a laparoscopy with targeted biopsy.
The totality of the results of these studies allows doctors to conclude the presence or absence of obstructive jaundice.
Obstructive jaundice: treatment of the disease
As a rule, all patients with a diagnosis of "obstructive jaundice" are immediately hospitalized in a surgical hospital. After the examination, the specialists proceed to the direct treatment of the disease. Usually the therapy of this disease is conservative. It is aimed at eliminating jaundice and cholestasis, as well as stabilizing the patient's condition. In this case, the treatment is carried out by taking hormonal drugs and using endoscopic methods.
Surgical steps are also often used to eliminate jaundice.
Surgery is performed to decompress (that is, to reduce pressure) in the biliary tract, as well as to resume the flow of bile, prevent liver failure and cirrhosis of the liver. In this case, not only open operations are used, but also laparoscopic ones, which are carried out under the control of ultrasound or CT. By the way, the latter is given particular preference due to the low likelihood of complications and a small incision.
Other treatments
In addition to surgical intervention, the complex scheme for the treatment of obstructive jaundice includes such activities as:
- hepatoprotection (taking B vitamins, the drug "Essentiale"), improving metabolism (by taking ascorbic acid and "Pentoxyl"), the use of ursodeoxycholic acid;
- detoxification therapy to stimulate diuresis, administration of glucose solution, saline solutions, sodiumchloride, hemodez;
- adjustment of microcirculation in the vessels of the liver;
- antibacterial treatment in case of attachment of an infectious process;
- hormone therapy, which is supplemented with agents for the prevention of gastrointestinal ulcers.
Outcome of surgery
It should also be noted that surgery for severe jaundice can have an unfavorable outcome. Therefore, such treatment is prescribed only for he alth reasons.
If the patient's condition allows, then it is necessary to wait for the cholestasis syndrome to subside, and then re-treat.
