The most causes of an icteric hepatoma are a late stage hepatocellular carcinoma or intrahepatic cholangiocarcinoma. A hepatocellular carcinoma, causing an obstrucution of the bile duct, rarely results in jaundice. With a late stage hepatocellular carcinoma, the accurate diagnosis and treatment may be difficult. Herein, we report a case of a hepatocellular carcinoma and obstructive jaundice, due to hilar tumor emboli, with a review of the literature.
Bile Ducts ; Carcinoma, Hepatocellular* ; Cholangiocarcinoma ; Diagnosis ; Jaundice* ; Jaundice, Obstructive

Computed tomographic (CT) scans of 46 jaundiced patients were studied to determine the value of CT in the diagnosis of biliary pathology. AII ofthe 12 cases of medical jaundice had positive CT correlation. Of the 34 cases of proven surgical jaundice, 97 .8% were correctly identified by CT. In detecting the level of obstruction, the cases were divided into four groups by anatomica l segments, according to the number of visualized low density ringlike structures produced by dilated bile duct. All of the correctly diagnosed surgical jaundice was 91.2%. The presence of stones or mass, the level of obstruction and the relative size and shape of visualized distal ring had proved to be the most important variables in etiological diagnosis of surgical jaundice. The results indicate that CT is useful and highly accurate in differenting between surgical (obstructive) jaundice and medical (non-obstructive) ajundice, and determining the level of obstruction and the etiology of surgical jaundice.
Bile Ducts ; Diagnosis ; Humans ; Jaundice ; Jaundice, Obstructive ; Pathology

The value of ultrasonography and percutaneous transhepatic cholangiography in determining the site and etiology of biliary obstruction with surgical jaundice was studied in 30 patients. All diagnoses were subsequently made by surgery and pathology. The results were as follows; 1. In ultrasonography, the site of obstruction was delineated in 46%, while the etiology of the lesion was established in 40%, In comparison, percutaneous transhepatic cholangiography delineated the site in 100% and the etilogy in 93%. 2. Although the percutaneous transhepatic cholangiography is invasive to the human body, it is considered to be the single procedure of choicein the managment of the patient with biliary obstructive jaundice because of its diagnostic accuracy, technical simplicity and relative safety.
Cholangiography ; Diagnosis ; Human Body ; Humans ; Jaundice ; Jaundice, Obstructive ; Pathology ; Ultrasonography

Humans ; Infant, Newborn ; Jaundice, Neonatal ; diagnosis ; therapy

Although pulmonary tuberculosis is known to be the most common type in tuberculosis, it actually can affect any organ system. However, abdominal type is very rare among the extra-pulmonary types, and obstructive jaundice caused by lymphadenopathies due to tuberculosis is especially uncommon manifestation even in endemic areas. Tuberculous lymphadenopathies can mimic lymphadenopathies by other metastatic tumors or lymphoma, thus early correct diagnosis is very important for avoiding unnecessary surgical interventions. Here, we reported two cases of obstructive jaundice caused by tuberculous lymphadenopathies. Both were treated with anti-tuberculosis medications and endoscopic retrograde biliary drainage without surgery.
Diagnosis ; Drainage ; Jaundice ; Jaundice, Obstructive* ; Lymphatic Diseases ; Lymphoma ; Tuberculosis ; Tuberculosis, Pulmonary

In 101 jaundiced patients, gray scale ultrasonography of longitudinal scan in RAO position demonstrated themeasurable extrahepatic biliary system in 73 patient; 17 cases (50%) of those with nonobstructive jaundice and 56cases (84%) of those with obstructive jaundice. The size of the internal diameter of extrahepatic biliary systemindicated that obstructive jaundice was best differentiated from non-obstructive jaundice when diameter above 7mm served as abnormal extrahepatic duct in jaundiced patients, giving sensitivity 85.5% specificity 97% anddiagnostic accuracy 89.5% by decision matrix analysis. The overall etiological diagnostic accuracy in obstructivejaundice was 40% which had higher one in choledocholithiasis and pancreas head carcinoma than other diseases. Thesonography should be imaging procedure of choice in differential diagnosis of jaundiced patients, which is simple, safe, noninvasive and has high diagnostic accuracy in differentiation between the two.
Bile Ducts, Extrahepatic ; Choledocholithiasis ; Diagnosis, Differential ; Head ; Humans ; Jaundice ; Jaundice, Obstructive ; Pancreas ; Sensitivity and Specificity ; Ultrasonography

We experienced a case of congenital choledochal cyst in a 6 months old korean female infant with complaints of abdominal distension, jaundice, loose stool and a large mass of the abdomenin the right upper quadrant since about 3 months prior to admission. The diagnosis was confirmed by clinical symptoms and signs, physical examination, radiological findings and surgical findings. She was operated with good result and discharged in well condition 28 days after. The review of the related literature was made briefly.
Choledochal Cyst* ; Diagnosis ; Female ; Humans ; Infant ; Jaundice ; Physical Examination

A Carcinoid tumor of the ampulla of Vater is extremely rare, accounting for less than 0.3% of all gastrointestinal carcinoids. Most reported cases have arisen from the gallbladder. An ampullary carcinoid most commonly presents with jaundice or upper abdominal discomfort, and bleeding from the tumor is exceedingly rare. A diagnosis is most frequently made postoperatively due to submucosal spread of the tumor. As the metastatic potential cannot be predicted by tumor size, a Whipple pancreaticoduodenectomy rather than local excision is considered the treatment of choice. We herein report a case of a primary carcinoid tumor located at the ampulla of Vater that presented as gastrointestinal bleeding; the tumor was diagnosed by an endoscopic biopsy after a papillary sphinterotomy.
Ampulla of Vater* ; Biopsy ; Carcinoid Tumor* ; Diagnosis ; Gallbladder ; Hemorrhage* ; Jaundice ; Pancreaticoduodenectomy

OBJECTIVETo investigate the research on neonatal jaundice in recent years by co-word analysis and to summarize the hot spots and trend of research in this field in China.

METHODSThe CNKI was searched with "neonate" and "jaundice" as the key words to identify the papers published from January 2009 to July 2013 that were in accordance with strict inclusion and exclusion criteria. To reveal the relationship between different high-frequency key words, Microsoft Office Excel 2013 was used for statistical analysis of key words, and Ucinet 6.0 and Netdraw were used for co-occurrence analysis.

RESULTSA total of 2 054 papers were included, and 44 high-frequency key words were extracted. The current hotspots of research on neonatal jaundice in China were displayed, and the relationship between different high-frequency key words was presented.

CONCLUSIONSThere has been in-depth research on clinical manifestations and diagnosis of neonatal jaundice in China, but further research is needed to investigate the etiology, mechanism, and treatment of neonatal jaundice.

Neonatal jaundice occurs in about 60% of newborns. If not managed properly, it can progress to severe neonatal jaundice (SNNJ) leading to death or permanent disability. The incidence of SNNJ in Kuching District increased from 119.3 per 100,000 live births in 2005 to 123.3 per 100,000 live births in 2008, which was above the Standard National QAP Indicator of 100 per 10,000 live births. SNNJ can be prevented by early detection and proper management of neonatal jaundice. The objective is to increase the knowledge and practise of early detection of neonatal jaundice by nurses in Kuching District. This was an interventional study covering a period of six months. The sample comprised 113 nurses of all categories working in urban and rural maternal and child health clinics in Kuching District. Tools used in the study were self-administered questionnaires in English and Bahasa Malaysia. The preintervention survey started in July 2009 while the post-intervention survey was done in January 2010. The interventions were done through Continuing Nursing Education sessions and included new nursing formats and new reporting procedures. New vehicles were also provided for home nursing. Data was collected and analyzed using MS Excel program. The pre-intervention survey on nurses showed that only 56.6% were able to identify the risk of factors causing jaundice; 94.6% able to define jaundice; 41.5% able to detect jaundice while 70.8% knew sign of Kernicterus. In term of recommended post natal nursing schedule only 40.7% able to practice the schedule while only 69.0% able to give advice on management of jaundice. Post intervention; 63.2% of nurses were able to identify the risk factors causing jaundice; 97.2% able to define jaundice while 97.2% were able to detect jaundice and 88.6% know sign of Kernicterus. On recommended postnatal nursing schedule, 49.9 % practice the recommended schedule while 92.0% were able to give advice to mother on management of jaundice. The incident of jaundice of Severe Neonatal Jaundice dropped to 78 per 100,000 live births in 2010. The study shows that the interventions taken helped to improve the knowledge and practice of recommended measures to detect neonatal jaundice early. Stronger emphasis must be placed on using the new reporting procedures and new nursing sheets. Continuous monitoring through regular nursing audits by clinic supervisors is also essential to reduce the incidence of SNNJ. Provision of vehicles for all busy maternal and child health clinics for home nursing care is highly recommended.
Knowledge ; Early Diagnosis ; Jaundice, Neonatal ; Nurses ; Nurse's Practice Patterns