Abstract:
Jaundice is not disease but rather a sign that can occur in many different diseases.(1)
Recent experience indicates that a more definitive role is possible for ultrasonography (US) in the evaluation of jaundice, ultrasound enables the physician to distinguish between obstructive jaundice and haemostatic liver disease, ultrasound not only allow the detection of obstructive jaundice, but also determine the cause and the level of obstruction with sensitivity and specificity varying between (55-91%) and (82-95) respectively.
A recent study, show that initial ultrasound is better than initial CT scan in patients suspected having acute biliary disease, follow up CT within 48 hours did not provide additional information regarding the biliary system. Therefore, its use should be limited to those patients with wider differential diagnosis or with confusing clinical symptoms and sign.
Ultrasonography is a uniquely safe and non-invasive means of imaging internal anatomy, change depicted include change in organ size, shape, echogenicity and echo pattern. This limited number of parameters may be affected by wide range of disease processes, thus it is not surprising that many sonographic features are non specific. In addition, the ultrasonographer, must not only demonstrates as many sonograhpic abnormalities as possible but must also interpreted these abnormalities in the light of many clinical information given, and the result of other investigation. It is thus not surprising the diagnostic accuracy of ultrasonogrsphy is very observer dependent and dependent not only upon knowledge of ultrasonography, but also knowledge of anatomy, pathology, and allied subject. Skill and experience of the sonographer shorten the way to correct diagnosis or direct the clinician to the further relevant investigation.(2)
Ultrasound compared to the other method is:
safe
cheap
portable
available
no contraindication
