Jaundice in pancreatic diseases

3. Jaundice in pancreatic diseases blog
  • Jaundice is yellowing of the eyes, skin & urine. It can occur due to many illnesses most commonly related to liver.

    Sometimes, the first sign of jaundice is darker urine. As bilirubin levels in the blood increase, the urine becomes brown in color.

    Bilirubin normally helps give stools their brown color. If the bile duct is blocked, stools might be light-colored or gray. Also, if bile and pancreatic enzymes can’t get through to the intestines to help break down fats, the stools can become greasy and might float in the toilet.

    When bilirubin builds up in the skin, it can start to itch as well as turn yellow.

Jaundice is caused by the buildup of bilirubin, a dark yellow-brown substance made in the liver. Normally, the liver releases a liquid called bile that contains bilirubin. Bile goes through the common bile duct into the intestines, where it helps break down fats. It eventually leaves the body in the stool. When the common bile duct becomes blocked, bile can’t reach the intestines, and the amount of bilirubin in the body builds up.
  • Cancers that start in the head of the pancreas are near the common bile duct. These cancers can press on the duct and cause jaundice while they are still fairly small, which can sometimes lead to these tumors being found at an early stage. But cancers that start in the body or tail of the pancreas don’t press on the duct until they have spread through the pancreas. By this time, the cancer has often spread beyond the pancreas.

    When pancreatic cancer spreads, it often goes to the liver. This can also cause jaundice.

    Pancreatic cancer is not the most common cause of jaundice. Other causes, such as gallstones, hepatitis, and other liver and bile duct diseases, are much more common.

  • Chronic pancreatitis is a condition where pancreas becomes hard & stony. It may block the bile duct passing through the head of pancreas. The reason for blockage is either an external compression or narrowing of the bile duct.
    • If a Pancreatic cancer is blocking the liver’s bile duct  then your doctor may recommend either a surgery called ‘whipple’s procedure’ or an endoscopy.

      With endoscopy – a plastic or metal tube (stent) is placed inside the bile duct to hold it open. This is done with the help of a procedure called endoscopic retrograde cholangiopancreatography (ERCP). During the procedure an endoscope is passed down your throat, through your stomach and into the upper part of your small intestine. A dye is then injected into the pancreatic and bile ducts through a small hollow tube (catheter) that’s passed through the endoscope. Finally, images are taken of the ducts.

      If the jaundice is secondary to chronic pancreatitis, then your doctor may recommend a surgical procedure called ‘Hepaticojejunostomy’.

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Dr. Harsh J Shah