Jaundice caused by obstruction of the biliary tract is called obstructive jaundice. It is a condition where the flow of bile out of the liver is obstructed. Due to the obstruction, there is an overflow of bile with its by-products into the blood and excretion of bile from the body gets affected. Bilirubin is a pigment, yellow in colour and it is derived from dead red blood cells. The concentration of bilirubin in blood plasma higher than 1.8 mg/DL causes jaundice and yellowing of eyes and skin. If no Urobilinogen is found in the urine, it is a sign of total obstruction of the bile duct. It shows that bilirubin is obstructed and its flow into the intestine where it gets converted to urobilinogen is obstructed. Most common obstruction is caused by gallstones. Other causes of obstruction of the bile duct are:
- Inherent structural abnormalities.
- Narrowing of bile ducts.
- Inflammation of the bile duct.
- Pancreatic cancer.
- Cysts of the bile duct.
- Enlargement of lymph nodes.
- Parasitic infection.
SYMPTOMS: Depending upon the extent of the obstruction, the symptoms may differ. Some patients having obstructive jaundice experience no symptoms at all, in the initial stage. At a later stage most of the patients experience fever, nausea with or without vomiting, severe abdominal pain (in the right upper quadrant of the abdomen) and yellowing of eyes and skin. Other common symptoms of obstructive jaundice are, dark coloured urine, diarrhoea, itchy-skin, loss of appetite, lethargy, pale stools and bruising.
CONSEQUENCES IF NOT TREATED:
If ignored or left untreated for a considerable length of time, obstructive jaundice leads to serious and fatal infection that affects other parts too of the body. Serious complications arise from obstructive jaundice like:
- Cirrhosis ( scar liver)
- A blood clotting disorder called ‘Coagulopathy’.
- Liver failure.
- Spread of cancer.
- A disorder in absorption of nutrients from food called ‘Mal-absorption Syndrome’.
RECOMMENDATIONS: Treatment to be taken on time which is done by assessing the severity of obstructive jaundice and the underlined cause.
TREATMENT: Assessing the severity and the underlined cause following course of action is taken by the doctors:
- Nutrition support.
- Intravenous fluids and pain killers.
- Repairing of anatomical defects or creating alternative pathways to facilitate the flow of bile, with the help of surgery.
- Liver transplantation (in case the liver is damaged).
- Antibiotic therapy (in case there is an indication of infection).
- ERCP (Endoscopic retrograde cholangio pancreatography): treatment of bile ducts and removal of gallbladder stone.
- Chemotherapy or radiation therapy: in case of pancreatic cancer.