DETECTION OF JAUNDICE IN PATIENTS OF ACUTE CHOLECYSTITIS IN SURGCAL DEPARTMENT

Abstract

Aim Of Study: To determine the detection of jaundice in patient of acute cholecystitis in surgical department. Study Design: Prospective observational study. Place & Dura Tion: Two years study from July 2018 to June 2020 was conducted in the Department of surgery Surgical unit 1 ward 2 at Liaquat University of Medical and Health Sciences, Jamshoro. Patients & Method: The prospective observational study was carried out in the Department of Surgery surgical unit 1 ward 2 at Liaquat University of Medical & Health Sciences, Jamshoro. The study comprises 100 patients, all patients were admitted from outpatient department ( OPD ) .The patients were evaluated fully after history ,clinical examinations Murphy’s sign, eye Sign & specific investigations of Liver function test Serum Bilirubin,Aspiratate transaminase (AST0,Alanine transaminase (ALT) Alkaline phosphatase and Gama G T, ultra sound of abdomen ,Hi imino dia acetic acid (HIDA SCAN), in acute cholecystitis Prothrombin time (PT) Activated Partial Thomboplastin Time (APTT) serum amylase, Magnetic resonance cholangiopancreatography (MRCP) , Computed tomography (CT), Endoscopic retrograde cholangio pancreatography .( ERCP ). Magnetic resonance imaging (MRI), percutaneous trans hepatic cholangiography (P T C) x- ray chest and abdomen. To exclude other pathology. Results: In this study 100 patients of acute cholecystitis. The maximum number of patients were in age range Between 18 to 80 years. 30 patients were in age group 18 to 39 year, 42 patients were in age group 40 to 60 years and 28 patients were in age group 61 to 80 year. 16 patients were presented with positive murphy’s sign. 59 patients were presented with deep tenderness, vomiting anorexia nausea and 25 patients were presented with pain ,jaundice ,fever with rigors. 16 patients were presented with bilirubin level range between 1 to 2mg with positive HBSAG, 59 patient were presented with bilirubin range between .5 to 1mg. 25 patient were presented with bilirubin range between 2 to 5 mg . 64 patient were treated by cholecystectomy with in 72 hours and 27 patient were treated by cholecystectomy after six week interval and 9 patients were treated by Radiological guided stone Extraction ,Fragmentation or Dissolution by Methyl tert-butylether (MTBE) and Percutaneous Lithotripsy due to un fit for surgery. Conclusion: Choleycystitis is a critical problem all over the word initially patient is asymptomatic then patient present with pain, in right hypochondriaum , pain radiate to back of right site, vomiting ,fever ,with or without jaundice fever with rigors if patient having normal amylase operate with in 72 hours or after six week