Diagnostic accuracy of ultrasonography in adults with obstructive jaundice

Abstract

Aim of the study: To determine the sensitivity and specificity of ultrasound for detecting the causes of obstructive jaundice. Materials and methods: Eighty adult patients with clinical and biochemical features of obstructive jaundice were enrolled in this study. The causes, degrees and levels of ductal obstruction were evaluated sonographically via the transab-dominal route. The ultrasonographic diagnoses were correlated with surgical findings and histopathological diagnoses. Results: The age range was 16 to 82 years, with a mean of 51.06 ± 14.95 years. The peak age group was the sixth decade with 23 (28.8%) patients. There were nearly twice as many females as males, with 28 (35%) males and 52 (65%) females, giving a male to female ratio of 1:1.9. On ultrasound, pancreatic carcinoma (28.0%) and choledocholithiasis (21.3%) were the most common malignant and benign causes of obstructive jaundice, respectively. Hepatocellular carcinoma (1.3%) was the least common etiology. There was a strong correlation between the definitive diagnosis and the sonographic level of obstruction. The overall sensitivity of ultrasound for detecting the cause of obstruction was 76.6%, while the specificity was 98%. Conclusion: Ultrasonography is a reliable imaging modality for diagnosing the cause and level of obstruction in surgical jaundice. The sensitivity is adequate to aid the early institution of surgical intervention, thereby preventing morbid-ity and mortality that may accompany late interventions in our setting.