Ultrasound evaluation of obstructive jaundice in patients presenting to a 'one-stop' jaundice clinic. A retrospective audit in a single centre.
Caron Dames, Georgina Edwards, Rebecca Murphy, Thomas Welsh, Peter Cantin, University Hospitals Plymouth NHS Trust, Derriford Hospital
Background
The initial evaluation of obstructive jaundice involves distinguishing intra and extra-hepatic biliary obstruction. The goal of any radiologic procedure in obstructive jaundice is to confirm the presence of biliary obstruction by detecting biliary dilatation, identify the location and extent of the obstruction and to identify the probable cause of the obstruction.
Ultrasound is readily available and does not use ionising radiation and is therefore used as a first-line investigation for jaundice within our unit. The efficacy of ultrasound in the evaluation of obstructive jaundice is highly variable within the literature. Ultrasound is able to distinguish between obstructive and non-obstructive jaundice in approximately 90% of cases. Demonstration of the level and cause of jaundice by ultrasound varies within the literature but should be established in around 60% of cases.
Aim
To determine the proportion of patients presenting with obstructive jaundice who have the level and cause of jaundice established on preliminary ultrasound.
Setting and Method
Patient selection for this audit will be those patients who have previously presented to the ‘one-stop’ jaundice clinic within our institution. The reference standard will be the results of other imaging (MRI, CT, ERCP) and review of patient medical records.
The ultrasound reports of patients included within the audit will be retrospectively reviewed and compared with subsequent imaging/patient records to determine the number of patients in whom the cause of jaundice was correctly established by ultrasound.
Audit Standard
Ultrasound is expected to correctly determine the cause of obstructive jaundice in 60% of cases.
Results
The audit is ongoing. We will present the results during this poster presentation.