Etiology, Clinical Presentations, and Short-Term Treatment Outcomes of Extrahepatic Obstructive Jaundice in South-Western Uganda

dc.contributor.authorCharles Newton, Odongo
dc.contributor.authorCarlos Cabrera, Dreque
dc.contributor.authorDavid, Mutiibwa
dc.contributor.authorFelix, Bongomin
dc.contributor.authorFelix, Oyania
dc.contributor.authorMvuyo Maqhawe, Sikhondze
dc.contributor.authorMoses, Acan
dc.contributor.authorRaymond, Atwine
dc.contributor.authorFred, Kirya
dc.contributor.authorMartin, Situma
dc.date.accessioned2023-07-10T14:32:26Z
dc.date.available2023-07-10T14:32:26Z
dc.date.issued2022-11-13
dc.description.abstractBackground: The diagnosis of extrahepatic obstructive jaundice (EHOJ) remains a challenge and is often made late in low-resource settings. Systematic data are limited on the etiology and prognosis of patients with obstructive jaundice in Uganda. The objective of this study was to determine the etiology, clinical presentations, and short-term treatment outcomes of patients managed for EHOJ at Mbarara Regional Referral Hospital (MRRH) in south-western Uganda. Methods: Between September 2019 and May 2020, we prospectively enrolled a cohort of patients who presented with EHOJ at MRRH. A pretested, semi-structured data collection tool was used to abstract data from both the study participants and their files. Results: A total of 72 patients, 42 (58.3%) of whom were male with a median age of 56 (range of 2 months to 95 years) were studied. Forty-two (58.3%) participants had malignancies: Pancreatic head tumors 20 (27.8%), cholangiocarcinoma 13 (18.1%), duodenal cancers 5 (6.94%), and gall bladder cancer 4 (5.6%). The remaining 30 (41.7%) participants had benign etiologies: choledocholithiasis 10 (13.9%), biliary atresia 7 (9.7%), pancreatic pseudo cyst 6 (8.3%), Mirizzi syndrome 5 (6.9%) and 1 (1.4%) each of chronic pancreatitis and choledochal cyst. Sixty-seven (93.1%) patients presented with right upper quadrant tenderness, 65 (90.3%) abdominal pain and 55 (76.3%) clay-colored stool. Cholecystectomy 11 (25.6%) and cholecystojejunostomy + jejunojejunostomy 8 (18.6%) were the commonest procedures performed. Twelve (17.0%) of cases received chemotherapy (epirubicin/cisplatin/capecitabine) for pan creatic head tumors and (gemcitabine/oxaliplatine) for cholangiocarcinoma. Mortality rate was 29.2% in the study, of which malignancy carried the highest mortality 20 (95.24%). Conclusion: Malignancy was the main cause of EHOJ observed in more than half of the patients. Interventions aimed at early recognition and appropriate referral are key in this population to improve outcomes.en_US
dc.description.sponsorshipNoneen_US
dc.identifier.citationCharles Newton Odongo, Carlos Cabrera Dreque, David Mutiibwa, Felix Bongomin, Felix Oyania, Mvuyo Maqhawe Sikhondze, Moses Acan, Raymond Atwine, Fred Kirya & Martin Situma (2022) Etiology, Clinical Presentations, and Short-Term Treatment Outcomes of Extrahepatic Obstructive Jaundice in South-Western Uganda, Clinical and Experimental Gastroenterology, , 79-90, DOI: 10.2147/CEG.S356977en_US
dc.identifier.urihttps://ir.sun.ac.ug//handle/123456789/55
dc.language.isoenen_US
dc.publisherClinical and Experimental Gastroenterology journalen_US
dc.subjectUganda, malignant obstructive jaundice, benign obstructive jaundiceen_US
dc.titleEtiology, Clinical Presentations, and Short-Term Treatment Outcomes of Extrahepatic Obstructive Jaundice in South-Western Ugandaen_US
dc.typeArticleen_US

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