Surgical jaundice among Ethiopian inpatients in a university hospital

The purpose of the study is to describe the pattern of surgical jaundice and outcome on inpatients, with literature review.

A retrospective data of medical records of surgical inpatients was used at Tikur Anbessa Hospital Department of Surgery, Addis Ababa University. Information on patients was retrieved from admission reports, operating theatre registers, surgical records, and discharge summaries and death certificates. Clinical data on demographic characteristics, clinical features, diagnosis and treatment, and in hospital outcome were entered into SPSS software and analyzed.

Surgical jaundice predominantly affected older age groups and majority of patients were male. The most common presenting symptoms were progressive jaundice and non-colicky RUQ or epigastric pain. Majority of patients presented within 3 months of the onset of symptoms. Jaundice and abdominal tenderness were the most frequent signs. Ultrasonography was diagnostic of pancreatobiliary disease in 97% of the patients. The most common operations performed for CBD stone were CBD exploration and choledochoduodenostomy whereas the most frequent operation done for pancreatic head tumor was cholecystojejunostomy. Majority of patients had malignant jaundice with male preponderance. All patients who died in the hospital had significant bilirubin level derangements and most were older than 50 years.

Surgical jaundice is a disease of the older age groups. Presentation with jaundice is usually a late presentation, which adversely impacts survival. For accurate and early etiologic diagnosis and appropriate intervention, diverse imaging facilities should develop.