DIFFERENTIAL DIAGNOSIS OF JAUNDICE IN SURGICAL PRACTICE

IN THE past two decades, several developments have influenced our clinical thinking in regard to jaundice. Many studies of the physiology of the liver in health have been made, and laboratory methods for studying hepatic disease have been developed. The latter have tended to detract from the time-honored and thoroughly tested clinical study of the jaundiced patient. The observations on the pandemic of infectious hepatitis during World War II have emphasized the importance of the parenchymatous type of jaundice. Some sequelae of this disease, such as homologous serum jaundice—serious and often fatal—acute and subacute atrophy and possibly chronic atrophy or cirrhosis, remain as current problems. Radical surgical procedures have been used for the relief of obstruction due to carcinoma of the ampulla of Vater and the head of the pancreas and for the relief of portal hypertension. Recognition of pancreatitis as a more frequent and clearcut syndrome has become disseminated