The document provides an overview of obstructive jaundice including its causes, anatomy and physiology of the biliary tract, and laboratory findings associated with it. It outlines intraluminal, mural, and extrinsic causes of jaundice and highlights key diagnostic lab results such as increased bilirubin levels and enzymes. An algorithm for diagnosing obstructive jaundice is also included, along with related clinical problems that healthcare professionals should be aware of.

1. OBSTRUCTIVE
JAUNDICE
INTRODUCTION
Dr.B.Selvaraj MS;Mch;FICS;
Professor Of Surgery
Melaka Manipal Medical college
Melaka 75150 Malaysia

2. Must to know core clinical
problems
1.Acute RLQ pain
2.Acute RUQ pain
3.Acute epigastric pain
4.Acute LLQ pain
5.Dysphagia
6.Abdominal lumps
7.Upper GI haemorrhage
8.Lower GI haemorrhage
9.Obstructive Jaundice
10.Breast lumps, mastalgia & nipple discharge
11.Neck swellings- Thyroid & non thyroidal
12.Groin swellings
13.Scrotal swellings
14.Limb ischemia- Acute & Chronic
15.Varicose veins
16.Renal & ureteric colic
17.Hematuria
18.Acute retention of urine

3. Obstructive Jaundice- Introduction
Causes of obstructive jaundice
Anatomy of biliary tract
Physiology of jaundice
Labs in obstructive jaundice
Algorithm in obstructive jaundice

4. Obstructive Jaundice- Causes
• Intraluminal causes:
- Choledocholithiasis
- Clonorchis sinensis
- Ascariasis & Schitosomiasis
• Mural causes:
- Malignant stricture-cholangiocarcinoma
- Benign stricture- Scelerosing cholangitis
• Extrinsic Causes:
- Ca Head of Pancreas
- Periampullary Carcinoma, Portal LN

5. Anatomy of Biliary Tract

6. Physiology of Jaundice

7. Labs in all types of Jaundice

8. Labs in Obstructive Jaundice
Bilirubin in the urine (characteristic
dark colouration) this occurs as the
bilirubin is conjugated and thus
water-soluble
No urobilinogen in the urine; due to
the obstruction, no bilirubin enters
the bowel to be converted to
urobilinogen.
Increased total bilirubin and direct
bilirubin(conjugated bilirubin)
 Increased canalicular enzymes: alkaline
phosphatase and GGT
Increased liver enzymes ALT and AST;
not as significant as seen in
hepatocellular causes, but biliary
backpressure inevitably leads to mild
hepatocyte damage.

9. Obstructive Jaundice-
Diagnostic Algorithm

10. THANK YOU
To watch the video version go
to:
youtube.com/c/surgicaleducator