Clinico-Radiological Profile of Obstructive Jaundice in a Tertiary Care Setting

Abstract Background: Obstructive jaundice (OJ) is a common surgical condition caused by bile flow obstruction, leading to conjugated hyperbilirubinemia and clinical features such as jaundice, pruritus, and clay-colored stools. The etiology varies from benign causes like choledocholithiasis to malignant conditions such as pancreatic or biliary tumors. Accurate diagnosis relies on a combination of clinical evaluation, biochemical tests, and imaging modalities, including ultrasound (USG), computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP). Early intervention is crucial to prevent complications and improve patient outcomes. This study aimed to evaluate the clinicoradiological profile of patients with obstructive jaundice in a tertiary care hospital. Methods: A prospective observational study was conducted in the Department of General Surgery, GMC, Jammu, over one year. A total of 200 patients with OJ were enrolled after excluding those with medical jaundice or postoperative cases. Detailed clinical history, physical examination, and biochemical tests (bilirubin, liver enzymes, complete blood count, coagulation profile) were recorded. Radiological evaluation included USG, CT, and MRCP. Data were analyzed using SPSS v19.0, with descriptive statistics for quantitative variables and chi-square tests for associations (p < 0.05 considered significant). Results: The mean age of participants was 45.05 ± 10.60 years, with a female predominance (80%) and most residing in urban areas (83.5%). Common comorbidities included diabetes (10%) and obesity (7%). The most frequently presenting symptoms were jaundice (22%), vomiting (18.5%), and right hypochondrial pain with fever (18%). Laboratory findings revealed elevated total bilirubin (5.02 ± 3.03 mg/dL), direct bilirubin (3.18 ± 1.91 mg/dL), and alkaline phosphatase (227.98 ± 48.39 IU/L). Imaging results showed gallstones and biliary sludge as the leading causes (20% each on USG), while MRCP identified CBD stones in 66.2% of cases. CT scans revealed pancreatic head obstruction in 64.5% of evaluated patients. Conclusion: Obstructive jaundice mainly affects middle-aged females, with choledocholithiasis as the primary cause. Ultrasound is the initial diagnostic tool, while MRCP and CT offer detailed assessments for complex cases.