Mechanical jaundice

Mechanical jaundice

Mechanical jaundice is a pathological syndrome caused by impaired outflow of bile from the bile ducts and the development of cholestasis.

Causes of obstructive jaundice:

1. Malformations (atresia, common bile duct cysts, duodenal diverticula located near the major duodenal papilla).

2. Gallstone disease, stones in the common bile and hepatic ducts, impacted stones of the major duodenal papilla.

3. Inflammatory strictures and stenoses (bile duct strictures, inflammatory or cicatricial papillostenosis).

4. Inflammatory diseases (acute cholecystitis, pericholecystitis, cholangitis, pancreatitis, alveolar echinococcosis in the area of ​​the porta hepatis).

5. Tumors (papillomatosis of the bile ducts, cancer of the hepatic and common bile ducts, major duodenal papilla, head of the pancreas, metastases and lymphomas in the porta hepatis).

With obstructive jaundice, the flow of bile into the intestines is disrupted, which leads to the accumulation of bilirubin, bile salts and lipids in the blood. Hyperbilirubinemia, stool discoloration, and skin itching develop.

Diagnosis of obstructive jaundice includes biochemical tests, ultrasound, endoscopic retrograde cholangiopancreatography, computed tomography.

Treatment depends on the cause and includes endoscopic, surgical and medical methods. The goal is to restore the patency of the bile ducts. If treatment is not timely, severe complications may develop.

Mechanical jaundice is an acute, well-defined jaundice that occurs as a result of blockage of the common bile duct by a stone or tumor. Unlike obstructive jaundice caused by choledocholithiasis, the reasons for the formation of gallstones in obstructive jaundice often remain unclear; obstruction of the bile ducts can be caused by both cholelithiasis and neoplasm; proinflammatory cytokines, the concentration of which sharply increases in portions of bile during cholelithiasis, may be present before the onset of acute pancreatitis. The presence of congenital pathology of the biliary system requires special care from the surgeon.