PDF(Pubmed)
Abstract：
UNASSIGNED: The diagnosis of obstructive jaundice (OJ) is a challenge and is often made late especialy in low-resource settings. There is a paucity of data on the aetiology and prognosis of patients with obstructive jaundice in Malawi and Sub-Saharan Africa. The objective of this study was to determine the aetiology, clinical presentations, and short-term treatment outcomes of patients managed for OJ in Malawi.
UNASSIGNED: A review of case notes of all patients admitted with a clinical diagnosis of OJ from 2012 to 2022 was done. We reviewed the clinical presentation, laboratory findings, management, intra and post-operative complications, and patient outcomes. Data was entered into an Excel spreadsheet and analysed using SPSS version 25.
UNASSIGNED: Of 26,796 patient admissions, 5339 (19.9%) were for non-trauma abdominal symptoms, of which 164 (0.6% of surgical admissions and 3% of abdominal symptoms) were for obstructive jaundice. Ages varied from 16 to 89 years. Females were 45 (58.4 %) of the population. The commonest presenting complaint was jaundice followed by abdominal pain and distention. The mean duration of symptoms at presentation was 8.5 weeks. The most frequent imaging modality was abdominal ultrasound 50(65 %). Twenty-six patients (33.8 %) were discharged with a diagnosis of obstructive jaundice of undetermined pathogenesis. The commonest diagnosis was pancreatic cancer 20(26.0 %) followed by Choledocholithiasis11(14.3 %). Patients younger than 50 years had the same likelihood of presenting with cancer as those older than 50 years.
UNASSIGNED: It is important to have a high index of suspicion in all adult patients presenting with obstructive jaundice as patients younger than 50 years have a similar risk of malignancy as older patients.
UNASSIGNED: A review of case notes of all patients admitted with a clinical diagnosis of OJ from 2012 to 2022 was done. We reviewed the clinical presentation, laboratory findings, management, intra and post-operative complications, and patient outcomes. Data was entered into an Excel spreadsheet and analysed using SPSS version 25.
UNASSIGNED: Of 26,796 patient admissions, 5339 (19.9%) were for non-trauma abdominal symptoms, of which 164 (0.6% of surgical admissions and 3% of abdominal symptoms) were for obstructive jaundice. Ages varied from 16 to 89 years. Females were 45 (58.4 %) of the population. The commonest presenting complaint was jaundice followed by abdominal pain and distention. The mean duration of symptoms at presentation was 8.5 weeks. The most frequent imaging modality was abdominal ultrasound 50(65 %). Twenty-six patients (33.8 %) were discharged with a diagnosis of obstructive jaundice of undetermined pathogenesis. The commonest diagnosis was pancreatic cancer 20(26.0 %) followed by Choledocholithiasis11(14.3 %). Patients younger than 50 years had the same likelihood of presenting with cancer as those older than 50 years.
UNASSIGNED: It is important to have a high index of suspicion in all adult patients presenting with obstructive jaundice as patients younger than 50 years have a similar risk of malignancy as older patients.
摘要：
■梗阻性黄疸（OJ）的诊断是一项挑战，通常在资源不足的情况下尤其如此。在马拉维和撒哈拉以南非洲，关于阻塞性黄疸患者的病因和预后的数据很少。这项研究的目的是确定病因，临床表现,以及马拉维接受OJ治疗的患者的短期治疗结果。
■对2012年至2022年临床诊断为OJ的所有患者的病例记录进行了回顾。我们回顾了临床表现，实验室发现,管理,术中和术后并发症，和患者结果。将数据输入到Excel电子表格中并使用SPSS版本25进行分析。
■在26,796名患者中，5339（19.9%）为非外伤腹部症状，其中164例(手术入院的0.6%和腹部症状的3%)为阻塞性黄疸.年龄从16岁到89岁不等。女性占人口的45（58.4％）。最常见的主诉是黄疸，然后是腹痛和腹胀。出现时症状的平均持续时间为8.5周。最常见的成像方式是腹部超声50（65％）。26例（33.8％）出院，诊断为病因不明的阻塞性黄疸。最常见的诊断是胰腺癌20（26.0％），其次是胆总管11（14.3％）。50岁以下的患者与50岁以上的患者患癌症的可能性相同。
■对于所有出现梗阻性黄疸的成年患者，高度怀疑是很重要的，因为50岁以下的患者与老年患者有相似的恶性肿瘤风险。
■对2012年至2022年临床诊断为OJ的所有患者的病例记录进行了回顾。我们回顾了临床表现，实验室发现,管理,术中和术后并发症，和患者结果。将数据输入到Excel电子表格中并使用SPSS版本25进行分析。
■在26,796名患者中，5339（19.9%）为非外伤腹部症状，其中164例(手术入院的0.6%和腹部症状的3%)为阻塞性黄疸.年龄从16岁到89岁不等。女性占人口的45（58.4％）。最常见的主诉是黄疸，然后是腹痛和腹胀。出现时症状的平均持续时间为8.5周。最常见的成像方式是腹部超声50（65％）。26例（33.8％）出院，诊断为病因不明的阻塞性黄疸。最常见的诊断是胰腺癌20（26.0％），其次是胆总管11（14.3％）。50岁以下的患者与50岁以上的患者患癌症的可能性相同。
■对于所有出现梗阻性黄疸的成年患者，高度怀疑是很重要的，因为50岁以下的患者与老年患者有相似的恶性肿瘤风险。
