In daily life, we often hear this saying, "Your skin has turned yellow recently. Is there a problem with your liver?" Is this true?
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The biliary duct obstruction can also lead to jaundice
In fact, the reason why our skin yellowing is not just liver disease.
In medicine, the skin or eyes are yellow due to diseases, which we call jaundice.
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In adults, common jaundice includes three types:
First is hepatocellular jaundice that we are familiar with, which is caused by damage to hepatocytes.
Second is obstructive jaundice due to obstruction of bile ducts.
3 is hemolytic jaundice caused by the destruction of erythrocytes .
It can be seen from this that Not all jaundice is caused by liver disease .
So, why does biliary obstruction cause yellowing of the skin?
First of all, the bile pigment in bile is like a dye, which is the culprit that causes our skin to turn yellow.
Bile is synthesized by the liver. The synthesized bile needs to be excreted into the intestine through the bile tract to participate in the digestion of food. Finally, most of it is excreted from the body through the stool.
In this process, biliary duct acts like a water pipe, which plays the role of transporting bile.
If this water pipe is blocked, then the bile will naturally not be discharged smoothly and then reabsorbed, entering the blood circulation of our body .
At this time, the skin and sclera of the whole body will be dyed yellow by this "dye", which will appear as we mentioned above that the skin of the whole body will turn yellow and the sclera will turn yellow.
In addition, patients will also experience yellow urine and white stools.
Careful friends may ask, why do the skin, sclera, and urine turn yellow, while the stool turns white?
This is because after bile tract obstruction, bile cannot be discharged into the intestines, so there is no chance to yellow the stool, so white clay -like stool appears.
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only can the root cause be alleviated so that obstruction
bile tract diseases that can cause obstructive jaundice are mainly as follows:
1. biliary tumor In addition to the yellowing of the skin, sclera, urine, white clay stool, there are also symptoms such as abdominal pain and weight loss.
2.Bire tract stones also manifests as yellowing of the skin, sclera, urine, white clay-like stool, abdominal pain, and may also have chills, high fever and other symptoms.
3.Bire stenosis bladder tract blockage of bile tract. The symptoms are similar to the above two.
When you find that your skin is yellow, it is recommended to go to the hepatobiliary department of a regular hospital immediately. Doctors generally recommend you draw blood, do color ultrasound, take CT, or do magnetic resonance, and determine the cause after a complete examination. For
treatment, first of all, we can reduce symptoms and improve basic conditions through active anti-infection treatment, PTCD (percutaneous intrahepatic bile duct puncture drainage) and other methods. Then, treatment is carried out according to the specific cause.
If the obstruction caused by stones, try to remove the stones, including surgical incision and removal of the stones, ERCP (endoscopic retrograde cholangiopancreatography), etc.
If it is obstruction caused by tumors, in the early stage, we can actively operate, remove the tumor, and rebuild the digestive tract. However, many patients with biliary tumors are already in the late stage when they are treated and there is no chance of surgical resection.
For this, we can perform PTCD (percutaneous intrahepatic bile duct puncture drainage) under the guidance of imaging devices such as ultrasound, CT or DSA. Through subcutaneous puncture, a thin guide wire is sent to the bile duct and drainage tube is placed. This method can quickly solve the patient's symptoms such as jaundice and abdominal pain.But the disadvantage is that the patient needs to always connect the drainage tube to his stomach, causing inconvenience in life. Moreover, due to the loss of bile outside the body, the patient's digestive function will become worse, and electrolytes and acid-base imbalances are prone to occur.
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For this reason, we can also choose to enter the bile stent through the PTCD pipeline or duodenoscope, and use the bile stent to spread the tumor open, and bile can flow into the intestine along the stent. This not only solves the problem of yellowing of the skin caused by obstruction, but also solves the problem of poor digestive function. On this basis, we can also use chemotherapy, photodynamic therapy and other methods to treat the tumor itself.
Author｜Deputy Chief Physician of the Hepatobiliary and Pancreatic Cancer Center of Chongqing University Affiliated Cancer Hospital Luo Xianzhang
Source｜Family Medicine《October 2022 Issue 19
Editing｜Zhang Wanbo
Proofreading｜Zheng Ke
Second review｜Zhang Yue
Final review｜Liu Huiying Zhang Ruxian
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