Skip to main content
NCBI home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1975 Mar;122(3):206–216.

Algorithm for an aggressive diagnostic approach to obstructive jaundice.

R M Katon, M K Bilbao, J Rsoch
PMCID: PMC1129680  PMID: 1146291

Full text

PDF
206

Images in this article

208Figure 1.
on p.208
208Figure 2.
on p.208
209Figure 3.
on p.209
209Figure 4.
on p.209
210Figure 5.
on p.210
211Figure 6.
on p.211
211Figure 7.
on p.211
212Figure 8.
on p.212
213Figure 9.
on p.213

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acosta J. M., Fotheringham W. T., Ruiz L. O., Nardi G. L. Operative cholangiography. Arch Surg. 1969 Jul;99(1):29–32. doi: 10.1001/archsurg.1969.01340130031006. [DOI] [PubMed] [Google Scholar]
  2. Ammann R. W., Deyhle P., Butikofer E. Fatal nectotizing pancreatitis after peroral cholangiopancreatography. Gastroenterology. 1973 Feb;64(2):320–323. [PubMed] [Google Scholar]
  3. Aronsen K. F., Lunderquist A., Nylander G. The comparison of celiacography and direct portography in the diagnostic evaluation of liver diseases. Radiology. 1969 Feb;92(2):313–322. doi: 10.1148/92.2.313. [DOI] [PubMed] [Google Scholar]
  4. BALLARD H., BERNSTEIN M., FARRAR J. T. Fatty liver presenting as obstructive jaundice. Am J Med. 1961 Feb;30:196–201. doi: 10.1016/0002-9343(61)90091-2. [DOI] [PubMed] [Google Scholar]
  5. BECKETT A. G., LIVINGSTONE A. V., HILL K. R. Acute alcoholic hepatitis. Br Med J. 1961 Oct 28;2(5260):1113–1119. doi: 10.1136/bmj.2.5260.1113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. BILLING B. H., WILLIAMS R., RICHARDS T. G. DEFECTS IN HEPATIC TRANSPORT OF BILIRUBIN IN CONGENITAL HYPERBILIRUBINAEMIA: AN ANALYSIS OF PLASMA BILIRUBIN DISAPPEARANCE CURVES. Clin Sci. 1964 Oct;27:245–257. [PubMed] [Google Scholar]
  7. Beal J. M. Diagnosis of obstructive jaundice. Arch Surg. 1968 Jun;96(6):863–868. doi: 10.1001/archsurg.1968.01330240009003. [DOI] [PubMed] [Google Scholar]
  8. Bilbao M. K., Frische L. H., Dotter C. T., Rösch J. Hypotonic duodenography. Radiology. 1967 Sep;89(3):438–443. doi: 10.1148/89.3.438. [DOI] [PubMed] [Google Scholar]
  9. Blumgart L. H., Cotton P. B., Burwood R., Lawrie B., Salmon P., Davies G. T., Beales J. S., Skirving A., Read A. E. Endoscopy and retrograde choledochopancreatography in the diagnosis of the jaundiced patient. Lancet. 1972 Dec 16;2(7790):1269–1273. doi: 10.1016/s0140-6736(72)92648-7. [DOI] [PubMed] [Google Scholar]
  10. Boijsen E., Reuter S. R. Combined percutaneous transhepatic cholangiography and angiography in the evaluation of obstructive jaundice. Am J Roentgenol Radium Ther Nucl Med. 1967 Jan;99(1):153–161. doi: 10.2214/ajr.99.1.153. [DOI] [PubMed] [Google Scholar]
  11. Bolt R. J. Differentiation of extrahepatic and intrahepatic obstructive jaundice. Ariz Med. 1970 May;27(5):70–71. [PubMed] [Google Scholar]
  12. Bookstein J. J., Reuter S. R., Martel W. Angiographic evaluation of pancreatic carcinoma. Radiology. 1969 Oct;93(4):757–764. doi: 10.1148/93.4.757. [DOI] [PubMed] [Google Scholar]
  13. Bornhurst R. A., Heitzman E. R., McAfee J. G. Double-dose drip-infusion cholangiography. An analysis of 107 consecutive cases. JAMA. 1968 Nov 11;206(7):1489–1494. [PubMed] [Google Scholar]
  14. Bourke J. B., Swann J. C., Brown C. L., Ritchie H. D. Exocrine pancreatic function studies, duodenal cytology, and hypotonic duodenography in the diagnosis of surgical jaundice. Lancet. 1972 Mar 18;1(7751):605–608. doi: 10.1016/s0140-6736(72)90407-2. [DOI] [PubMed] [Google Scholar]
  15. Bree R. L., Flynn R. E. Hypotonic duodenography in the evaluation of choledocholithiasis and obstructive jaundice. Am J Roentgenol Radium Ther Nucl Med. 1972 Oct;116(2):309–319. doi: 10.2214/ajr.116.2.309. [DOI] [PubMed] [Google Scholar]
  16. CHALMERS T. C., GILL R. J., JERNIGAN T. P., SVEC F. A., JORDAN R. S., WALDSTEIN S. S., KNOWLTON M. Evaluation of a four-day ACTH test in the differential diagnosis of jaundice. Gastroenterology. 1956 Jun;30(6):894–899. [PubMed] [Google Scholar]
  17. Cooperman L. R., Rossiter S. B., Reimer G. W., Ng E. Infusion cholangiography. Thirteen years experience with 1,600 cases. Am J Roentgenol Radium Ther Nucl Med. 1968 Dec;104(4):880–883. [PubMed] [Google Scholar]
  18. Cotton P. B. Cannulation of the papilla of Vater by endoscopy and retrograde cholangiopancreatography (ERCP). Gut. 1972 Dec;13(12):1014–1025. doi: 10.1136/gut.13.12.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. DATTA D. V., SHERLOCK S., SCHEUER P. J. POST-NECROTIC CIRRHOSIS WITH CHRONIC CHOLESTASIS. Gut. 1963 Sep;4:223–230. doi: 10.1136/gut.4.3.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Deutsch V. Cholecysto-angiography. Visualization of the gallbladder by selective celiac and mesenteric angiography. Am J Roentgenol Radium Ther Nucl Med. 1967 Nov;101(3):608–616. [PubMed] [Google Scholar]
  21. Dickinson P. B., Belsito A. A. Duodenoscopy and retrograde cholangiopancreatography. A new method for diagnosis of obstructive jaundice. Minn Med. 1973 Oct;56(10):859–862. [PubMed] [Google Scholar]
  22. DuPriest R. W., Jr, Haines J. E., Rösch J., Krippaehne W. W. A comparison of scintiscans and arteriograms for identifying metastatic intrahepatic tumors. Surg Gynecol Obstet. 1973 May;136(5):705–710. [PubMed] [Google Scholar]
  23. Eade M. N. Liver disease in ulcerative colitis. I. Analysis of operative liver biopsy in 138 consecutive patients having colectomy. Ann Intern Med. 1970 Apr;72(4):475–487. doi: 10.7326/0003-4819-72-4-475. [DOI] [PubMed] [Google Scholar]
  24. Foy R. E., Jr Slow-infusion compared with direct- injection cholangiography. Application of zonography. Radiology. 1968 Mar;90(3):576–578. doi: 10.1148/90.3.576. [DOI] [PubMed] [Google Scholar]
  25. GALL E. A., DOBROGORSKI O. HEPATIC ALTERATIONS IN OBSTRUCTIVE JAUNDICE. Am J Clin Pathol. 1964 Feb;41:126–139. doi: 10.1093/ajcp/41.2.126. [DOI] [PubMed] [Google Scholar]
  26. Grace R. H., Peckar V. G. The value of operative cholangiography using an image intensifier and a television monitor. Br J Surg. 1968 Dec;55(12):933–938. doi: 10.1002/bjs.1800551213. [DOI] [PubMed] [Google Scholar]
  27. Göthlin J., Mansoor M., Tranberg K. G. Combined percutaneous transhepatic cholangiography (PTC) and selective visceral angiography (SVA) in obstructive jaundice. Am J Roentgenol Radium Ther Nucl Med. 1973 Feb;117(2):419–425. doi: 10.2214/ajr.117.2.419. [DOI] [PubMed] [Google Scholar]
  28. Hanafee W., Weiner M. Transjugular percutaneous cholangiography. Radiology. 1967 Jan;88(1):35–39. doi: 10.1148/88.1.35. [DOI] [PubMed] [Google Scholar]
  29. Hatfield A. R., Whittaker R., Gibbs D. D. The collection of pancreatic fluid for cytodiagnosis using a duodenoscope. Gut. 1974 Apr;15(4):305–307. doi: 10.1136/gut.15.4.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Herba M. J., Kiss J. Percutaneous transhepatic cholangiography. Experience with 106 examinations. J Can Assoc Radiol. 1971 Mar;22(1):22–29. [PubMed] [Google Scholar]
  31. Hines C., Jr, Ferrante W. A., Davis W. D., Jr, Tutton R. A. Percutaneous transhepatic cholangiography. Experience with 102 procedures. Am J Dig Dis. 1972 Oct;17(10):868–874. doi: 10.1007/BF02239524. [DOI] [PubMed] [Google Scholar]
  32. Ishak K. G., Irey N. S. Hepatic injury associated with the phenothiazines. Clinicopathologic and follow-up study of 36 patients. Arch Pathol. 1972 Apr;93(4):283–304. [PubMed] [Google Scholar]
  33. JUNIPER K., Jr Prolonged severe obstructive jaundice in Hodgkin's disease. Gastroenterology. 1963 Feb;44:199–204. [PubMed] [Google Scholar]
  34. KEIL P. G., LANDIS S. N. Peritoneoscopic cholangiography. AMA Arch Intern Med. 1951 Jul;88(1):36–41. doi: 10.1001/archinte.1951.03810070046006. [DOI] [PubMed] [Google Scholar]
  35. Katon R. M., Lee T. G., Parent J. A., Bilbao M. K., Smith F. W. Endoscopic retrograde cholangiopancreatography (ERCP). Experience with 100 cases. Am J Dig Dis. 1974 Apr;19(4):295–306. doi: 10.1007/BF01072519. [DOI] [PubMed] [Google Scholar]
  36. Kaude J., Rian R. Cholangiocarcinoma. Radiology. 1971 Sep;100(3):573–580. doi: 10.1148/100.3.573. [DOI] [PubMed] [Google Scholar]
  37. Lorenzo G. A., Beal J. M. Recent diagnostic advances in obstructive jaundice. Surg Clin North Am. 1971 Feb;51(1):211–221. doi: 10.1016/s0039-6109(16)39342-2. [DOI] [PubMed] [Google Scholar]
  38. Mosenthal W. T. Peritoneoscopy. A neglected aid in the diagnosis of general medical and surgical disease. Am J Surg. 1972 Apr;123(4):421–428. doi: 10.1016/0002-9610(72)90194-8. [DOI] [PubMed] [Google Scholar]
  39. O'Toole J. S. Hypoxia in asthmatic attacks. Calif Med. 1970 Jun;112(6):44–44. [PMC free article] [PubMed] [Google Scholar]
  41. Pollard J. J., Nebesar R. A., Mattoso L. F. Angiographic diagnosis of benign diseases of the liver. Radiology. 1966 Feb;86(2):276–283. doi: 10.1148/86.2.276. [DOI] [PubMed] [Google Scholar]
  42. RUBIN E., SCHAFFNER F., POPPER H. PRIMARY BILIARY CIRRHOSIS. CHRONIC NON-SUPPURATIVE DESTRUCTIVE CHOLANGITIS. Am J Pathol. 1965 Mar;46:387–407. [PMC free article] [PubMed] [Google Scholar]
  43. Redman H. C., Reuter S. R. The angiographic evaluation of gallbladder dilatation. Radiology. 1970 Nov;97(2):367–370. doi: 10.1148/97.2.367. [DOI] [PubMed] [Google Scholar]
  44. Rourke J. A., Bosniak M. A., Ferris E. J. Hepatic angiography in "alcoholic hepatitis". Radiology. 1968 Aug;91(2):290–296. doi: 10.1148/91.2.290. [DOI] [PubMed] [Google Scholar]
  45. Rösch J., Grollman J. H., Jr, Steckel R. J. Arteriography inthe diagnosis of gallbladder disease. Radiology. 1969 Jun;92(7):1485–1491. doi: 10.1148/92.7.1485. [DOI] [PubMed] [Google Scholar]
  46. Rösch J., Lakin P. C., Antonovic R., Dotter C. T. Transjugular approach to liver biopsy and transhepatic cholangiography. N Engl J Med. 1973 Aug 2;289(5):227–231. doi: 10.1056/NEJM197308022890501. [DOI] [PubMed] [Google Scholar]
  47. SCHMID M., HEFTI M. L., GATTIKER R., KISTLER H. J., SENNING A. BENIGN POSTOPERATIVE INTRAHEPATIC CHOLESTASIS. N Engl J Med. 1965 Mar 18;272:545–550. doi: 10.1056/NEJM196503182721101. [DOI] [PubMed] [Google Scholar]
  48. SCHULTZ J. C., ADAMSON J. S., Jr, WORKMAN W. W., NORMAN T. D. FATAL LIVER DISEASE AFTER INTRAVENOUS ADMINISTRATION OF TETRACYCLINE IN HIGH DOSAGE. N Engl J Med. 1963 Nov 7;269:999–1004. doi: 10.1056/NEJM196311072691903. [DOI] [PubMed] [Google Scholar]
  49. SHALDON S., SHERLOCK S. Virus hepatitis with features of prolonged bile retention. Br Med J. 1957 Sep 28;2(5047):734–738. doi: 10.1136/bmj.2.5047.734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. SMITH M. P., LOE R. H. SCLEROSING CHOLANGITIS; REVIEW OF RECENT CASE REPORTS AND ASSOCIATED DISEASES AND FOUR NEW CASES. Am J Surg. 1965 Aug;110:239–246. doi: 10.1016/0002-9610(65)90018-8. [DOI] [PubMed] [Google Scholar]
  51. SUMMERSKILL W. H. THE SYNDROME OF BENIGN RECURRENT CHOLESTASIS. Am J Med. 1965 Feb;38:298–305. doi: 10.1016/0002-9343(65)90184-1. [DOI] [PubMed] [Google Scholar]
  52. SVANBORG A., OHLSSON S. Recurrent jaundice of pregnancy; a clinical study of twenty-two cases. Am J Med. 1959 Jul;27(1):40–49. doi: 10.1016/0002-9343(59)90059-2. [DOI] [PubMed] [Google Scholar]
  53. Sherlock S. Halothane hepatitis. Gut. 1971 Apr;12(4):324–329. doi: 10.1136/gut.12.4.324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Stern R. B., Knill-Jones R. P., Williams R. Pitfalls in the diagnosis of jaundice due to carcinoma of the pancreas or biliary tree. Br Med J. 1973 Mar 3;1(5852):533–534. doi: 10.1136/bmj.1.5852.533. [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Strack P. R., Newman H. K., Lerner A. G., Green S. H., Meng C. H., Del Guercio L. R., State D. An integrated procedure for the rapid diagnosis of biliary obstruction, portal hypertension and liver disease of uncertain etiology. N Engl J Med. 1971 Nov;285(22):1225–1231. doi: 10.1056/NEJM197111252852204. [DOI] [PubMed] [Google Scholar]
  56. Sáfrány L., Tari J., Barna L., Török I. Endoscopic retrograde cholangiography. Experience of 168 examinations. Gastrointest Endosc. 1973 May;19(4):163–168. doi: 10.1016/s0016-5107(73)73990-0. [DOI] [PubMed] [Google Scholar]
  57. Thorbjarnarson B. The anatomical diagnosis of jaundice by percutaneous cholangiography and its influence on treatment. Surgery. 1967 Mar;61(3):347–354. [PubMed] [Google Scholar]
  58. Tylén U. Accuracy of angiography in the diagnosis of carcinoma of the pancreas. Acta Radiol Diagn (Stockh) 1973 Jul;14(4):449–466. doi: 10.1177/028418517301400410. [DOI] [PubMed] [Google Scholar]
  59. Vennes J. A., Silvis S. E. Endoscopic visualization of bile and pancreatic ducts. Gastrointest Endosc. 1972 May;18(4):149–152. doi: 10.1016/s0016-5107(72)74061-4. [DOI] [PubMed] [Google Scholar]
  60. Viamonte M., Jr, Warren W. D., Fomon J. J. Liver panangiography in the assessment of portal hypertension in liver cirrhosis. Radiol Clin North Am. 1970 Apr;8(1):147–167. [PubMed] [Google Scholar]
  61. WERNER S. C., HANGER F. M., KRITZLER R. A. Jaundice during methyl testosterone therapy. Am J Med. 1950 Mar;8(3):325–331. doi: 10.1016/0002-9343(50)90065-9. [DOI] [PubMed] [Google Scholar]
  62. Weiner M., Hanafee W. N. A review of transjugular cholangiography. Radiol Clin North Am. 1970 Apr;8(1):53–68. [PubMed] [Google Scholar]
  63. Wruble L. D., Kalser M. H., Jones R. H., Vloedman D., Bachorik P. Jaundice. Value of five-day steroid test in differential diagnosis. JAMA. 1966 Jan 17;195(3):184–188. doi: 10.1001/jama.195.3.184. [DOI] [PubMed] [Google Scholar]
  64. Young W. B. Obstructive jaundice, the radiologist, the surgeon, and the patient: Caldwell Lecture, 1971. Am J Roentgenol Radium Ther Nucl Med. 1973 Sep;119(1):4–39. doi: 10.2214/ajr.119.1.4. [DOI] [PubMed] [Google Scholar]
  65. Zarday Z., Veith F. J., Gliedman M. L., Soberman R. Irreversible liver damage after azathioprine. JAMA. 1972 Nov 6;222(6):690–691. [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES