Ultrasound in the diagnosis of jaundice--a review

A retrospective study of 92 jaundiced patients undergoing ultrasound examination was undertaken to assess the clinical utility of this test. The patients were graded according to the likelihood of biliary obstruction. In those in whom biliary obstruction was proven to be present, the sensitivity of ultrasound to detect the obstruction was 91% and the test specificity was 100%. In patients who had undergone cholecystectomy no increase in the diameter of the common duct was observed. Liver function tests proved to be unreliable in discriminating between extrahepatic obstructive jaundice and other forms of jaundice. Ultrasound scanning is a useful screening test in the diagnosis of the jaundiced patient. However, follow-up is suggested for those with a negative result of this test but in whom biliary obstruction is suspected. An approach to the investigation of the jaundiced patient should include early ultrasound examination in those with possible biliary obstruction.