A STATISTICAL AND CLINICO-PATHOLOGIC STUDY OF JAUNDICE IN AUTOPSY MATERIALS; WITH SPECIAL REFERENCE TO OBSTRUCTIVE JAUNDICE
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The protocols of 4312 cases, the autopsy materials of recent 10 years at the Department of Pathology, Faculty of Medicine, University of Tokyo, have been reviewed. Among these, 1077 (25%) cases with hyperbilirubinemia or jaundice were found. The detailed descriptions were made about these jaundiced cases. Main results were as follows:1) The cause of jaundice was clear in 73% (A-group), suspectable in 10% (B-group), and obscure in 17% (C-group).2) In (A)-group the relative frequency of various conditions causing jaundice, was shown in the following order: Extrahepatic bile duct obstruction due to malignant neoplasms (28%), Nodular hepatic malignancy (23%), Hepatitis of a broad sense (14%), Liver cirrhosis (12%), Chronic active liver congestion (9%), etc.3) In (B) and (C)-group the factors relating to the cause of jaundice, consisted mainly of severe general infection, hepatotoxic drugs, liver congestion, blood transfusion, hemolysis, and diffuse tumor cell infiltration of the liver. Such factors were often found in leukemia or post-operative cases.4) In (C)-group intestinal obstruction, especially of the duodenum or jejunum, was suspected to be one of the possible causative factors of obstructive jaundice.5) Extrahepatic mechanical-obstructive jaundice was found in 32% of overall (A)group, and in its 87% biliary obstructions were due to malignant neoplasms (mostly carcinoma): Gastric (23%), Pancreatic (21 %), Choledochal (18%), Gall bladder (15%), Papilla of Vater (6%), etc. Among these mechanical-obstructive jaundice, biliary decompression would have been able to prolong their life, even for a short time, in 76% cases, and complete cure might have been expected in 31 cases (13%) if accurate diagnosis and adequate treatment had been made: 16 cases of cholelithiasis and 15 cases of pancreatic or choledochal cancer of rather early stage.In addition, relationship between degree or duration of jaundice and histological findings of the liver were studied in detail.
- 財団法人 日本消化器病学会の論文
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- A STATISTICAL AND CLINICO-PATHOLOGIC STUDY OF JAUNDICE IN AUTOPSY MATERIALS; WITH SPECIAL REFERENCE TO OBSTRUCTIVE JAUNDICE