Cholestasis: Difference between revisions

Jump to navigation Jump to search
No edit summary
mNo edit summary
 
(29 intermediate revisions by 7 users not shown)
Line 1: Line 1:
__NOTOC__
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{Cholestasis}}
{{CMG}}


{{CMG}}
{{SK}} Cholestatic jaundice; conjugated hyperbilirubinaemia; obstruction of bile duct; obstructive jaundice; acholuria; biliary stasis
{{Cholestasis}}
{{Editor Help}}


==[[Cholestasis overview|Overview]]==


{{Infobox_Disease |
==[[Cholestasis pathophysiology|Pathophysiology]]==
  Name          = {{PAGENAME}} |
  Image          = |
  Caption        = |
  DiseasesDB    = 9121 |
  ICD10          = {{ICD10|K|71|0|k|70}}, {{ICD10|K|83|1|k|80}} |
  ICD9          = {{ICD9|576.2}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = ped |
  eMedicineTopic = 383 |
  MeshID        = D002779 |
}}


==[[Cholestasis overview|Overview]]==
==[[Cholestasis causes|Causes]]==


==Etiology==
==[[Cholestasis differential diagnosis|Differentiating Cholestasis from other Diseases]]==
* [[Gallstone]]s
* [[Abdominal mass]] (e.g. [[cancer]])
* [[Primary sclerosing cholangitis]], secondary to [[inflammatory bowel disease]]
* [[Primary biliary cirrhosis]], secondary to autoimmune disorders
* Congenital anomalies of the bilary tract
* Biliary [[Physical trauma|trauma]]
* Some drugs, (e.g. [[Flucloxacillin]] and [[Erythromycin]])
* In children, [[biliary atresia]] and other pediatric liver diseases
* [[Pregnancy]], referred to as [[Intrahepatic Cholestasis of Pregnancy]], or Obstetric Cholestasis


==Histopathology==
==[[Cholestasis risk factors|Risk Factors]]==
Under a [[microscope]], the individual hepatocytes will have a brownish-green stippled appearance within the [[cytoplasm]], representing bile that cannot get out of the cell.  Canalicular bile plugs between individual hepatocytes or within bile ducts may also be seen, representing bile that has been excreted from the hepatocytes but cannot go any further due to the obstruction.  When these plugs occur within the bile duct, sufficient pressure (caused by bile accumulation) can cause them to rupture, spilling bile into the surrounding [[biological tissue|tissue]], causing hepatic [[necrosis]].  These areas are known as bile lakes, and are typically seen only with extra-hepatic obstruction.
==[[Cholestasis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Symptoms==  
==Diagnosis==
* Pale stools, 
[[Cholestasis history and symptoms|History and Symptoms]] | [[Cholestasis physical examination|Physical Examination]] | [[Cholestasis laboratory findings|Laboratory findings]] | [[Cholestasis CT|CT]] | [[Cholestasis MRI|MRI]] | [[Cholestasis ultrasound|Ultrasound]] | [[Cholestasis other imaging findings|Other Imaging Findings]] | [[Cholestasis other diagnostic studies|Other Diagnostic Studies]]
* dark urine,
* itchiness ([[pruritus]]) and
* [[jaundice]]


[[Bile]] is secreted by the liver to aid in the [[digestion]] of [[fats]].  Drugs such as [[gold salts]],[[nitrofurantoin]], [[anabolic steroids]], chlorpromazine, prochlorperazine, sulindac, cimetidine, [[erythromycin]], can cause cholestasis and may result in damage to the [[liver]].
==Treatment==
[[Cholestasis medical therapy|Medical Therapy]] | [[Cholestasis surgery|Surgery]] | [[Cholestasis prevention|Prevention]] | [[Cholestasis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Cholestasis future or investigational therapies|Future or Investigational Therapies]]


== Differential Diagnosis of Cholestasis ==
==Case Studies==
* After liver transplantation
[[Cholestasis case study one|Case #1]]
* After ulcer surgery
* [[Alagille Syndrome]]
* [[Alcoholic Hepatitis]]
* [[Alpha-1 Antitrypsin Deficiency]]
* [[Amebiasis]]
* [[Amyloidosis]]
* Bile duct carcinoma
* Bile duct calculi
* Bile duct cysts
* [[Biliary atresia]]
* [[Budd-Chiari Syndrome]]
* [[Bylers Syndrome]]
* Carbonic anhydrase inhibitors
* [[Caroli's Syndrome]]
* Cholangiocellular carcinoma
* Cholecystectomy
* Choledochotomy with T-tube drainage
* Chronic active hepatitis
* [[Cryptosporidiosis]]
* [[Cystic Fibrosis]]
* Drugs
* [[Dubin-Johnson Syndrome]]
* Duodenal abscess
* [[Echinococcosis]]
* Familiar progressive cholestasis
* [[Hemochromatosis]]
* [[Hydatid cyst]]
* Idiopathic postoperative jaundice
* Idiopathic relapsing cholestasis
* Impaired bile acid synthesis
* Intermittent cholestasis
* Ischemia of other origin
* [[Leptospirosis]]
* [[Liver abscess]]
* [[Liver Cancer]]
* Liver cysts
* Liver metastases
* [[Lymphoma]]
* [[Mirizzi's Syndrome]]
* Neoplasm
* [[Pancreatic Cancer]]
* Pancreatic cyst
* [[Pancreatitis]]
* Pancreatoduodenectomy
* Papillary carcinoma
* Parasites
* Parasitosis
* Pericholedochal infection
* Postoperative
* [[Pregnancy]] cholestasis
* Primary and secondary [[sclerosing cholangitis]]
* [[Primary biliary cirrhosis]]
* [[Primary sclerosing cholangitis]]
* Rare congenital causes
* Relapsing cholangitis
* [[Reye's Syndrome]]
* [[Sarcoidosis]]
* [[Sepsis]]
* [[Sickle Cell Anemia]]
* Stenosis of the bile papilla
* Stricture
* Total parenteral nutrition
* Toxic, allergic
* [[Toxic Shock Syndrome]]
* [[Viral Hepatitis]]
* [[Wilson's Disease]]
* [[Zieve's Syndrome]]


==See also==
==Related Chapters==
*[[Jaundice]]
*[[Jaundice]]
*[[Liver function tests]]
*[[Liver function tests]]
Line 121: Line 32:
*[[Intrahepatic Cholestasis of Pregnancy]]
*[[Intrahepatic Cholestasis of Pregnancy]]


==External links==
*[http://www.nlm.nih.gov/medlineplus/ency/article/000218.htm Drug-induced cholestasis] - medlineplus.org
*[http://www.liverfamilies.net Liver Families] = pediatric liver support group
*[http://www.itchymoms.com/ Itchy Moms] - information about Obstetric Cholestasis / Cholestasis of Pregnancy
*[http://www.ocsupport.org.uk/ OC Support website] - OC Support website: information about Obstetric Cholestasis, research, support, shared experiences, discussion forum.


{{SIB}}
{{Gastroenterology}}
{{Gastroenterology}}


[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Hepatology]]
[[Category:Obstetrics]]
[[Category:Disease]]


[[pl:Cholestaza]]
[[pl:Cholestaza]]

Latest revision as of 14:21, 2 April 2015

For patient information click here

Cholestasis Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Differentiating Cholestasis from other Diseases

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Cholestasis On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Cholestasis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Cholestasis

CDC on Cholestasis

Cholestasis in the news

Blogs on Cholestasis

Directions to Hospitals Treating Cholestasis

Risk calculators and risk factors for Cholestasis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Cholestatic jaundice; conjugated hyperbilirubinaemia; obstruction of bile duct; obstructive jaundice; acholuria; biliary stasis

Overview

Pathophysiology

Causes

Differentiating Cholestasis from other Diseases

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory findings | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters


Template:Gastroenterology sv:Gallstas


Template:WikiDoc Sources