The Ultrasonic Diagnostic Analysis Of Obstructive Jaundice

Obstructive jaundice refers to when the bile ducts outside liver are blocked,the concentration of conjugated bilirubin in serum increases due to cholestasis. The skin,sclera,mucous membrance and body fluid will become yellow.It is normal when serum total bilirubin below 17.1umol/L.When it become higher than 34.2umol/L,people will appear yellow.The location and pathogeny of block is variable.It always caused by cholelithiasis,tumor and inflammatory narrow.Congenital heteroplasia,oppression from outside and factitious reasons are rare.To diagnose the location and reason of obstructive jaundice before operation is important for selection of therapy and evaluation of prognosis.We are going to discuss the valume of diagnosis and discrimination of location and pathogeny using ultrasonography.Watching gall bladder,right and left bile duct .common bill duct ,head of pancreas periampullae. First ,-4-determine if there is block or not. Then judge the quality of the lesion through observing the ultrasonographic characteristics of lesion,metastasis of other organs,and so on.We studied the result of ultrasound and operation or pathology of 96 patients with obstructive jaundice. Including,27 cases were cholelithiasis,the sensitivity was 77.8%, the accuracy was 87.5%. 16 cases were cholangioma, the sensitivity was 68.8%, the accuracy was 87.5%. 25 cases were pancreatic head cancer, the sensitivity was 64.0%, the accuracy was 86.5%. 10 cases were tumor of ampullae, the sensitivity was 50%, the accuracy was 90.6%. 14 cases were chronic inflammation, the sensitivity was 35.8%, the accuracy was 87.5%.2 cases were factitious reason,2 cases were congenital choledochocele.This study suggest the ultrasonography is convenient, handle,harmless,radioactiveless and repeatful. We can determine if there is backup. It is easier to judge the pathogeny when it is closer to liver.But it is difficult to distinguish the quality when the pathological changes located in the end of choledochus,head-5-of pancrease and ampullae. To distinguish the nature of lesion: characterless cholelith can easily be misdiagonosed for tumor in the end of common bile duct or ampullae.It is difficult for infiltrative cholangiocarcinoma,tumor of duodenal papilla,andampullae to be diagnosed before operation.Chronic inflammation and cancer of pancreatic head,inflammatory lesion and small mass of umpullae are difficult to distinguish. These satuations need further research.