Jaundice overview

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

Overview

Jaundice is yellowish discoloration of the skin, conjunctiva (a clear covering over the sclera, or whites of the eyes) and mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in red blooded animals). Usually the concentration of bilirubin in the blood must exceed 2–3 mg/dL for the coloration to be easily visible.

Causes

When red blood cells die, the heme in their haemoglobin is converted to bilirubin in the spleen and in the hepatocytes in the liver. The bilirubin is processed by the liver, enters bile and is eventually excreted through feces.

Consequently, there are three different classes of causes for jaundice. Pre-hepatic or hemolytic causes, where too many red blood cells are broken down, hepatic causes where the processing of bilirubin in the liver does not function correctly, and post-hepatic or extrahepatic causes, where the removal of bile is disturbed.

Diagnosis

History and Symptoms

Common symptoms of jaundice that the patient will notice, is yellowing of the skin, nausea, and vomiting. Specific symptoms will depend on the underlying factor that caused jaundice to occur.

CT

Abdominal CT scan may be helpful

Other Diagnostic Studies

Endoscopic retrograde cholangio-pancreatography (ERCP)

Treatment

Surgery

Cholecystectomy or ERCP

References


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