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Abstract Ultrasonography should be used as the initial non invasive screening test in patients with suspected obstructive jaundice as it is very easy, safe, cheap and highly accurate in detection of biliary obstruction. In the present study 32 patients with obstructive jaundice were included, 18 females and 14 males with age ranging between 35 years and 70 years. All cases were submitted to full clinical examination, and Routine leboratory investigations. Ultrasonographic examination was done for all patients. E.R.C.P. was done for 23 cases of them, CT scanning was performed for 12 cases while PTC was performed for 5 cases. The final diagnosis was reached by exploration, endoscopic biopsy and needle biopsy. In our study the most common causes of obstruction were choledocholithiasis (40%). Cancer head of pancreas 28% and postcholecystectomy common bile duct trauma 12.5%. Ultrasonographic examination could correctly detect the presence of biliary obstruction and its level in all cases of our study, while could correctly define the cause of obstruction in 25 Patients 78%. C.T scanning could correctly diagnose the presence of obstruction in all cases examined. ERCP and PTC examination were very sensetive in defining the exact level and nature of obstructing lesion. from the results of the present study, we can conclud that: Ultrasonographic examination is a highly sensetive sereening method for jaundiced patients, to defferentiate between medical and surgical jaundice and also in differentiation between intrahepatic and extrahepatic causes of obstruction. Ultrasonography is not only of value in detection of biliary obstruction but it is also accurate in defining its level and cause pasticulary with meticulous, technique and high resolution machine. Other radiological modality as CT PTC or ERCP Should be chosen on the light of information gained by ultrasound. |