الفهرس 
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Abstract
Background: Obstructive jaundice is a common problem in the,edical and surgical gastroenterological practice. Malignant.bstructive jaundice can be caused by cancer head of pancreas,periampullary carcinoma, carcinoma of the gall bladder and<cholangiocarcinomas.Objective: to review the etiological spectrum of malignant<obstructive jaundice in NCI Cairo university during a period of 3years (2008 till 2010).Patients and methods: retrospective study including 232patients who presented with malignant obstructive jaundice<between (2008 to 2010).Data were collected from the biostatistics<and cancer epidemiology department.Results: out of 232 patients; 156 (67.2%) were male and 76(32.8%) were female; the median age of the study population was49 years (range 19_80years).The commonest cause of malignant obstructive jaundice was.ancreatic head cancer, 72% (167/232), followed by the ampullary.arcinoma 15% (36/232).The last cause was.holangiocarcinoma12.5% (29/233).Regarding the commonest.ymptom; clay colored stools (98.7%) was more frequent in.atients with malignant disease whereas abdominal pain (97.7%)was 2nd common symptom.Conclusion: Obstructive jaundice is more common among males.nd cancer head of pancreas is the commonest malignancy.US,ERCP and CT-Scan are important diagnostic modalities for,valuation of patient with obstructive jaundice with ERCP,aving the additional advantage of being therapeutic as well.Keywords: Obstructive jaundice, ERCP, Ca Head of.ancreas, Ca gall bladder.