الفهرس 
AbstractOnly 14 pages are availabe for public view
 |  | from | 140 |  |  |
| | | from | 140 | | |
Abstract
Aim : to determine the frequency of extrahepatic cholestasis in our department and its possible underlying causes , consequently we can decrease morbidity and mortality associated with this health problem Methods : 506 cases admitted to our department were subjected to serum alkaline phosphatase level and pelvi abdominal ultrasound, and those with ALP 1.5 times the normal confirmed with elevated serum GGT 3 times the normal and showing IHBRD with or without CBD dilatation were subjected to full history taking , complete systemic and local abdominal examination , routine laboratory investigations , abdominal CT and ERCP to detect the cause of billiary obstruction Results : out of 506 cases admitted to our department, 61 cases with extrahepatic cholestasis were detected with a percentage of 12.1% . 33 were female (54.1%) and 28 were male (45.9%). The mean age of cases with extrahepatic cholestasis was 51.1 years (range 25 – 72 years). Bengin obstructive jaundice was more common than malignant (57.4% VS 42.6%) . malignant obstructive jaundice was more common in elderly (60) years (66.7%) and in males (50%), while bengin was more common in younger age group (20 – 40) (85.7%) and in females (63.6%). The most common cause of extrahepatic cholestasis was choledocholithiasis 25/61 (40.9%) , followed by cancer head of pancreas 9/61 (14.8%) , periampullary carcinoma 8/61 (13.11%) , cholangiocarcinoma 5/61 (8.2%) , pancreatitis 4/61 (6.6%) , portahepatis lymphadenopathy 3/61 (4.9%) , cholangitis 2/61 (3.3%) , HCC 2/61 (3.3%) , duodenal diverticulum 1/61 (1.6%) , pancreatic pseudocyst 1/61 (1.6%) and iatrogenic CBD ligation 1/61 (1.6%) . Dark urine , clay stool and itching were more common in patients with malignant obstructive jaundice . Sensitivity of U/S, CT and ERCP in detection of CBD stones was 76% , 88% and 100% respectively, while in detection of cancer head of pancreas was 66.7% , 100% and 100% respectively.Conclusion : extrahepatic cholestasis has a high frequency 12.1% in our department , being more in females than males . malignant obstructive jaundice is more common in elderly and in males . choledocholithiasis is the most common bengin cause while cancer head of pancreas is the most common malignant . U/S, CT and ERCP are helpful diagnostic tools in detection of the cause of obstruction Key words: extra-hepatic cholestasis; cholidocholithiasis; cancer head of pancreas; ultrasonography; endoscopic retrograde.