What is obstructive jaundice? The causes of the development and treatment of this disease will be described below. You will also learn what symptoms are characteristic of this disease and how it is diagnosed.
Basic information
For 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, he has two factions: direct, that is related, and indirect, that is, free.
Thus, for obstructive jaundicecharacterized by excessive accumulation of the above element, which occurs as a result of full or partial overlap of the lumen of the biliary tract. Another name for this disease is obstructive jaundice.
The main causes of the disease
Differential diagnosis of the causes of obstructive jaundice should be carried out only in a hospital. We will tell about what research methods are used below.
In the normal state of the patient's bile,formed in the liver, should with a certain frequency be displayed 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 hinder such a process:
- стеноз, или так называемое сужение протоков, а also swelling of the mucous membrane in the presence of cicatricial post-inflammatory strictures (for example, observed with cholangitis or cholecystitis) or compression of the tumor;
- mechanical obturation, or the so-called overlap of a certain portion of the bile ducts by displaced calculi (stones) in the presence of gallstone disease.
All of these pathological phenomena lead to stagnation of bile (that is, the formation of cholestasis), resulting in hypoxia, which damages the hepatocytes.
It should be noted that the cause of obstructive jaundice may be an abscess, cyst of the gallbladder or pancreas, as well as parasites such as roundworm or echinococcus.
Symptoms of the disease
How does obstructive jaundice manifest itself? The symptoms of this disease are not difficult to notice. As a rule, such a disease develops acutely.
According to experts, jaundice is manifested by such signs as:
- nausea, fever, vomiting;
- excruciating stitching pains in the right hypochondrium, which grow in a wave-like manner and radiate to the right scapula or collarbone;
- stool discoloration, since bilirubin no longer enters the intestine;
- excretion of bilirubin 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 the disease
How can one recognize developmentobstructive jaundice? The disruption of the current of bile of a chronic nature occurs exactly as described above. However, the severity of these symptoms may increase depending on the duration of cholestasis. Also, in some cases, patients have steatorrhea (that is, undigested fat in the feces is detected), skin hyperpigmentation, loss of body weight, and xanthomas (that is, lipid deposits in the skin).
It should be noted that the timelyDifferential diagnosis of obstructive jaundice helps prevent the development of diseases such as cirrhosis. For this disease is characterized by the formation of connective tissue fibrous nodes in the liver, which occur in response to hepatocyte necrosis due to metabolic disorders and oxygen starvation.
With the development of jaundice in humansThe 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 the mechanicaljaundice often provokes the development of hemorrhagic syndrome, which includes nasal bleeding, the appearance of vascular "stars" and bruises on the skin. Such phenomena are a consequence of vitamin K deficiency.
With a shortage of vitamin A in the body, the patient's ability to twilight vision is reduced. In addition, prolonged cholestasis significantly increases the likelihood of the formation of gallstones.
Also, with the development of jaundice increases the riskinfection and the occurrence of bacterial cholangitis, or the so-called inflammation of the bile ducts. This condition is usually manifested by fever and pain in the upper right corner of the abdomen.
Methods for the diagnosis of obstructive jaundice
Now you know that for obstructivejaundice is characterized by elevated levels of bilirubin in the blood. However, a biochemical blood test with this disease does not give a complete diagnostic picture. Therefore, many experts conduct other laboratory tests, as well as use various instrumental methods.
So, for the diagnosis of obstructive jaundice is necessary:
- make a complete blood count;
- undergo endoscopic retrograde or magnetic resonance cholangiopancreatography;
- undergo computed tomography and ultrasound of the abdominal organs;
- do a laparoscopy with an aiming biopsy.
The totality of the results of these studies allows physicians to conclude that there is or is no jaundice.
Obstructive jaundice: treatment of the disease
As a rule, all patients are diagnosed“Obstructive jaundice” is immediately hospitalized in a surgical hospital. After the examination, specialists begin to directly treat the disease. Typically, the treatment 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.
Also, to eliminate jaundice, they often resort to surgical steps.
Оперативное вмешательство осуществляется с целью decompression (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. At the same time, not only open operations are used, but also laparoscopic, which are carried out under the control of ultrasound or CT. By the way, the second is given special preference because of the low probability of complications and a small incision.
Other treatments
In addition to surgical intervention, the complex scheme of treatment of obstructive jaundice includes such activities as:
- hepatoprotection (taking vitamins of group B, drug Essentiale), improving metabolism (by taking ascorbic acid and Pentoxil), using ursodeoxycholic acid;
- detoxification therapy to stimulate diuresis, the introduction of a solution of glucose, salt solutions, sodium chloride, hemodez;
- adjustment of microcirculation in the vessels of the liver;
- antibacterial treatment in case of accession of the infectious process;
- hormone therapy, which is supplemented by means 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, this treatment is prescribed only for health reasons.
If the patient's condition allows, then it is necessary to wait for the cholestasis syndrome to subside, and then repeat therapy.
