Medical Practice

Pitfalls in the Diagnosis of Jaundice due to Carcinoma of the Pancreas or Biliary Tree

Br Med J 1973; 1 doi: http://dx.doi.org/10.1136/bmj.1.5852.533 (Published 03 March 1973) Cite this as: Br Med J 1973;1:533
  1. R. B. Stern,
  2. R. P. Knill-Jones,
  3. Roger Williams

    Abstract

    Analysis of 56 patients with obstructive jaundice due to carcinoma of the pancreas or extrahepatic biliary tree showed that unexpected features were present in 25%. Presentation with painless jaundice was uncommon, and the symptoms were more often non-specific, with malaise, anorexia, and vomiting. Abdominal pain was frequent, and the condition was found in young patients. One-fifth presented with serum alkaline phosphatase levels of less than 30 K.A. units. Some had high serum aspartate aminotransferase levels, more characteristic of hepatocellular jaundice. A mathematical model may be helpful in correctly weighting these various criteria.

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