Page 1
Page 1
Jaundice
Jaundice in an adult patient can be caused by a wide variety of benign or life-threatening disorders. Organizing the differential diagnosis by prehepatic, intrahepatic, and posthepatic causes may help make the work-up more manageable. Prehepatic causes of jaundice include haemolysis and hematoma resorption, which lead to elevated levels of unconjugated (indirect) bilirubin. Intrahepatic disorders can lead to unconjugated or conjugated hyperbilirubinemia. The conjugated (direct) bilirubin level is often elevated by alcohol, infectious hepatitis, drug reactions, and autoimmune disorders. Posthepatic disorders also can cause conjugated hyperbilirubinemia. Gallstone formation is the most common and benign posthepatic process that causes jaundice; however, the differential diagnosis also includes serious conditions such as biliary tract infection, pancreatitis, and malignancies.
Jaundice
• Physiologic Anatomy Liver • HEMOGLOBIN FORMATION • Formation and Fate of Urobilinogen • Jaundice—Excess Bilirubin in the Extracellular Fluid • Hemolytic Jaundice Is Caused by Hemolysis of Red Blood Cells • Obstructive Jaundice Is Caused by Obstruction of Bile Ducts or Liver Disease • Diagnostic Differences Between Hemolytic and Obstructive Jaundice • Infant jaundice • Prolonged unconjugated hyperbilirubinemia associated with breast milk and mutations of the bilirubin uridine diphosphate-glucuronosyltransferase gene • Acute bilirubin encephalopathy • Hepatitis (A + B + C) • Immune system abnormaly • Jaundice in the adult
