Publication: Role of Ultrasound as Compared with ERCP in Patient With Obstructive Jaundice
Date
2013
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
The diagnosis of obstructive jaundice relies on proper history taking, clinical
examination, laboratory investigations and different non invasive imaging modalities
like Ultrasonography (USG), Cholangio Computed Tomography (CCT), Magnetic
resonance Imaging (MRI) with Magnetic Resonance Cholangio Pancreatography
(MRCP) and invasive modalities like endoscopic retrograde cholangiography (ERCP)
and percutaneous trans hepatic cholangiography (PTC).
Objective
To compare the role of ultrasound with endoscopic retrograde cholangiography
and to determine the major causes of obstructive jaundice in our prospect.
Methods
This was a prospective, analytical study conducted on 88 patients presenting to
Department of Radiodiagnosis and Imaging at Dhulikhel Hospital-Kathmandu
University hospital from March 2011 to August 2012 with clinical diagnosis
of obstructive jaundice. Sonographic evaluation was performed in Siemens
acusion x-150 and x-300. The final diagnosis was made by endoscopic retrograde
cholangiography and /or surgery and confirmed histopathologically.
Results
The most common benign causes of obstructive jaundice were choledocholithiasis
(63%), CBD stricture (12.3%), cholangitis (8%) and pancreatitis (6.85%) whereas
cholangio carcinoma (6.85%) and carcinoma head of pancreas (4%) comprised
of the malignant causes . Ultrasonography had sensitivity of 100% and specificity
of 89% in detecting choledocholithiasis. It was found to be 98.78% sensitive and
83.33% specific in cholangiocarcinoma. Similarly in pancreatitis, the sensitivity of
ultrasonography was 97.59% and sensitivity was 66.67%.
Conclusion
Ultrasonography acts as a valuable diagnostic imaging modality in detecting the
causes of obstructive jaundice. Due to its easy availability, non invasive nature
and cost effectiveness, it can be considered as the first line imaging technique/
tool. ERCP is the invasive imaging tool and can be used for both diagnostic and
therapeutic purpose.
KEY WORDS
ERCP, obstructive jaundice, ultrasonography
Description
Karki S,1 Joshi KS,1 Regmi S,1 Gurung RB,2 Malla B3
1Department of Radiodiagnosis and Imaging
2Department of Internal medicine
3Department of Surgery
Dhulikhel Hospital- Kathmandu University Hospital
Kathmandu University School of medical Science Dhulikhel Hospital, Kavre, Nepal