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간내 (肝內) 담즙정체성 (膽汁停滯性) 황달과 (黃疸) 기계적 (機械的) 폐한성 (閉寒性) 황달의 (黃疸) 임상적 (臨床的) 비교
이상철 ( S C Lee ),안득수 ( D s Ahn ),양형식 ( H S Yang ),이경 ( K Lee ),한남진 ( N J Han ),박행렬 ( H R Prak ) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.1
Cholestasis, literally translated, is stagnation of bile, but conventionally implies interfe- rence with bile flow into the duodenum associated with jaundice. Cholestasis has been divided into the type resulting from obstruction, either intrahepatic or extrahepatic, and that without obstruction, conventionally designated intrahepatic chol estasis. For the differenciation between intrahepatic cholestatic jaundice(medical jaundice,' and mechanical obstructive jaundice(surgical jaundice). We studied 102 cases of severe jaundice patients consisting of 54 cases of intrahepatic cholestatic, medical, jaundice confirmed by complete cure with medical treatment, who had over 20 mg% of serum total bilirubin, and 48 cases of mechanical obstructive, surgical, jaundice confirmed by operation, who had over 15 mg% of serum total bilirubin. The cases studied involved the patients who iwere admitted to department of internal medi- cine and/or transferred to department of general surgery for operation in Jeonbug National University Hospital andjeon Ju Presbyterian Medical Center during the period of Jan. 1979, to Dec. 1980. The results obtained are summerized as follows; 1. In surgical jaundice, the most common causes of diseases are stones and pancreatic head carcinoma, and those comprise 66. 6% of all surgical jaundice patients. In medical jaundice, the acute viral hepatitis(72. 2%) is the most common cause of disease and cirrhosis of the liver is next(14. 8%). 2. In surgical jaundice, 48% of patients is over 60 year old aged. 3. RL'Q pain, fever and chillness are more frequent in surgical jaundice than that in medical jaundice. Especially gall bladder was palpable in 20. 9% of surgical jaundice and in none of medical jaundice, 4. Mean+S.D. of serum alkaline phosphatase are 34 05+23.16 King-Armstrong unit in surgical jaundice and 17. 42+7. 48 King Armstrong unit in medical jaundice. 5. 6. 4% of surgical j;undice and 50% of medical jaundice show over 300 Karmen unit of SGOT and 2. 1% of surgical jaundice and 62 9% of medical jaundice show over pOQ Karmen unit of SGPT. But none of surgical jmndice showes over 900 Karman unit of SGOT and SGPT. SGOT/SGPT ratio showes 1. 67+0. 74 in surgical and 1. Og+0 gg in medical jaundice. 6. Mean+S.D. of serum cholesterol are 271. 73+91. 61 in surgical and 210. 56<81. 54 in med- ical jaundice. 7. SGOT/Alkaline phosphat;ase relation is not significant in differential diagnosis of sur- gical jaundice from medical jaundice because of low sensitivity (57. 2% in surgical jaundice .and 64. 7% in medical jaundice).
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