Jaundice: what it is, causes

One of the complications of various diseases of the hepato-biliary system is jaundice. This condition significantly complicates the course of the underlying disease and requires emergency medical assistance.

What is it?

Jaundice is a pathological condition caused by various reasons related to the blockage of the bile ducts. The disease is manifested by yellowing of skin, sclera, mucous membranes due to the violation of exchange of bilirubin and accumulation of its degradation products. The development of this condition significantly complicates the course of the underlying pathology and deteriorating health of the patient. This type of jaundice is almost always within the competence of the surgeon, because the problem is usually solved only by surgery.

The reasons for the development

There are two key groups of reasons for this pathology:

1. Benign. These include:

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  • The consequences and complications of gallstone disease (fistula, obstruction of the bile duct stones, inflammation or narrowing of the bile ducts).
  • Complications of ulcer of stomach or duodenum 12. Penetration of gastric ulcer into the region of the bile ducts or hepatic duodenal ligament can cause the development of such jaundice.
  • Pathology of the pancreas (cysts, acute and chronic inflammation of this area).
  • Congenital abnormalities of the biliary tract (atresia, stricture, split, etc.).
  • The presence of parasites in the digestive tract (roundworm, tapeworm, etc.).
  • The effects of surgical interventions on the organs of the digestive tract. This type of jaundice is also called iatrogenic.
  • Pathology 12 duodenal ulcer (duodenitis, diverticulum).
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2. Among malignant causes of this jaundice can lead:

  • neoplasms of the pancreas (cancer);
  • tumors of the bile ducts (sarcoma, carcinoma);
  • metastases in cancer of other organs, for example, in tumors of the stomach, kidneys and other organs.

Thus, the cause of the pathology can be more than 20 different diseases. The task of the expert is to eliminate the immediate causes of disease and relief from symptoms caused by such jaundice.

Important! Relatives and friends of the patient often wonder is contagious or not such a jaundice. As can be seen from the above reasons, get it because it is a consequence of other pathological processes, most of which are not contagious, with the exception of parasitic diseases.

Clinical signs and symptoms

Symptoms at onset and course of jaundice is largely determined by its cause. In tumors of the patient may be suffering quickly appears and increases itching, skin color is greenish, the body weight reduces, the fever in most cases. In benign causes of the symptoms are similar and yet have their differences:

  • body weight normal or elevated;
  • the first complaints of intense pain syndrome;
  • the beginning of a sudden, whereas in tumors the process progresses slowly;
  • the color of the mucous membranes and skin deep yellow;
  • often increased body temperature and fever.

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Diagnosis of obstructive jaundice

Given the clinical history and presumptive diagnosis, for each patient selected tests. What tests can be performed:

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  • Determination of laboratory parameters of General and biochemical blood tests, coagulogram, functional tests, urinalysis, immunogramma.
  • Ultrasound of the liver, gall bladder and other abdominal organs.
  • X-ray methods of research: survey, imaging, x-rays using the direct magnification, x-ray, using different methods of contrast enhancement. To contrast the bile ducts can be used both direct and indirect ways, if necessary, resort to the contrasting of the vessels of the liver.
  • Radioisotopic techniques: scanning, radioisotope hepatography, scintigraphy.
  • CT and NMR.
  • Endoscopic methods: fibrogastroduodenoscopy, laparoscopy.
  • Functional tests.
  • Biopsy.
  • Diagnosis during the surgical intervention: assess the size of the biliary tract, examine the ligaments and the liver condition. It is possible to conduct an ultrasound and a biopsy right during the operation.
  • In addition, sometimes I use mixed methods, for example, when fibrogastroduodenoscopy combined with ultrasound or simultaneously carry out a laparoscopy and x-rays.

    How to treat mechanical jaundice?

    Treatment of jaundice in most cases, operational. In rare cases, patients with helminthic infestation or acute pancreatitis may resolve the jaundice using drug therapy. It includes anti-inflammatory, detoxification, de-worming and other medications. The entire course of therapy, the patient is in the hospital. The surgical treatment of such jaundice is aimed at:

    • the elimination of the causes of jaundice;
    • the reorganization of the bile ducts;
    • unloading of the bile ducts.

    To solve these problems they use different types of surgical interventions (choledocholithotomy, cholecystectomy, etc.). When possible, preference is given to minimally invasive endoscopic techniques, which reduce post-operative risk and reduce the rehabilitation period.

    Life expectancy in these patients depends on the cause of the disease. With timely treatment of obstructive jaundice of benign Genesis lethality is not more than 5%. The development of renal and hepatic insufficiency, accompanying diseases, and older age increase this figure to 50 – 70%.

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