探究阻塞性黄疸的病因:单中心回顾性分析

M. Murshid, Abdulellah Talal Al-Alhazmi, Farrukh Alim Ansari
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摘要

背景:阻塞性黄疸是由胆汁流动受阻引起的一种病症,有各种良性和恶性病因。准确及时的诊断对有效治疗至关重要,尤其是在可能存在恶性肿瘤的情况下。诊断方法的进步提高了我们对疾病的认识和管理。本研究旨在调查沙特阿拉伯人阻塞性黄疸的病因和临床表现:本研究纳入了 2019 年 1 月至 2022 年 12 月期间外科病房收治的 193 名确诊为阻塞性黄疸的患者。方法包括综合临床评估、病史回顾、体格检查、实验室检查和影像诊断,以确定潜在疾病。系统收集数据并进行统计分析:研究共纳入 193 名患者,男女比例为 1:1.4,平均年龄为 54.10 岁。恶性病因(主要是胰头癌)占 59.4%,良性病因(主要是胆总管结石)占 41.6%。症状包括黄疸、腹痛和食欲不振,治疗方法因病因而异:这项研究强调,阻塞性黄疸多见于女性,年轻人多由良性疾病引起,而恶性病因则多见于老年人。最常见的恶性病因是胰头癌,主要的良性病因是胆总管结石。诊断梗阻性黄疸的主要成像技术包括磁共振胰胆管造影术(MRCP)、内镜逆行胰胆管造影术(ERCP)和计算机断层扫描(CT)。
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Exploring the causes of obstructive jaundice: a single-centre retrospective analysis
Background: Obstructive jaundice is a condition caused by bile flow blockage and has various benign and malignant etiologies. Accurate and timely diagnosis is essential for effective treatment, particularly in cases of possible malignancy. Advances in diagnostic methods have improved our understanding and management of diseases. This study aimed to investigate the causes and clinical presentation of obstructive jaundice in Saudi Arabian population. Methods: This study included 193 patients diagnosed with obstructive jaundice admitted to the surgical wards from January 2019 to December 2022. Methods involved comprehensive clinical evaluations, medical history reviews, physical examinations, laboratory tests, and diagnostic imaging to identify the underlying disease. Data were collected systematically and statistically analyzed. Results: The study included 193 patients with a male-to-female ratio of 1:1.4, and an average age of 54.10 years. Malignant causes, primarily carcinoma of the pancreatic head, accounted for 59.4% of cases, while benign causes, notably choledocholithiasis, accounted for 41.6%. Symptoms included jaundice, abdominal pain, and loss of appetite, with treatment varying according to the identified cause. Conclusions: The study highlights that obstructive jaundice is more commonly found in females and tends to be caused by benign conditions in younger people, while malignant causes are more prevalent in older individuals. The most common malignant cause is carcinoma of the pancreatic head, and leading benign cause is choledocholithiasis. For diagnosing obstructive jaundice, key imaging techniques include magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and computed tomography (CT).
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