What is an obstructive jaundice?
Obstructive jaundice is a specific type of jaundice, where symptoms develop due to a narrowed or blocked bile duct or pancreatic duct, preventing the normal drainage of bile from the bloodstream into the intestines.
Is obstructive jaundice conjugated or unconjugated?
Obstructive jaundice has hallmark findings on the biochemistry profile. It is primarily a conjugated hyperbilirubinemia with the direct bilirubin > 50% of the total bilirubin. There is also an associated elevation of alkaline phosphatase.
What is the pathophysiology of obstructive jaundice?
Obstructive jaundice produces a number of biochemical and physiologic alterations in the biliary tract. Acute cholangitis occurs in an infected, usually obstructed biliary system, at the level of the common bile duct. The most common cause of obstruction is stones.
Which blood cell is damaged in jaundice?
Jaundice happens when too much bilirubin builds up in your blood. This makes your skin and the whites of your eyes look strikingly yellowish. Bilirubin is a yellowish pigment created as hemoglobin — a component of red blood cells — is broken down.
What enzymes increase in obstructive jaundice?
The activity of enzymes, such as alkaline phosphatase, gamma-glutamyl transpeptidase, and leicine aminopeptidase, was found to be increased in the serum and tear of 28 patients with obstructive jaundice.
How does obstructive jaundice lead to hypercholesterolemia?
The exact mechanism of hypercholesterolemia in obstructive jaundice is not known but a defect in hepatic lipase and hepatic cholesterol synthesis has been hypothesized. Of note, hypercholesterolemia occurring in the setting of obstructive jaundice responds well to relief of the obstruction and not to medical therapy.
Why is urine yellow in obstructive jaundice?
In obstructive jaundice (both intrahepatic cholestasis and extrahepatic obstruction) the serum bilirubin is principally conjugated. Conjugated bilirubin is water soluble and is excreted in the urine, giving it a dark colour (bilirubinuria).
What is the most common cause of obstructive jaundice?
Stone disease is the most common cause of obstructive jaundice. Gallstones may pass through the CBD and cause obstruction and symptoms of biliary colic and cholangitis. Larger stones can become lodged in the CBD and cause complete obstruction, with increased intraductal pressure throughout the biliary tree.
What happens to red blood cells in jaundice?
Jaundice causes your skin and the whites of your eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. As red blood cells break down, your body builds new cells to replace them.
What is obstructive jaundice?
What is obstructive jaundice? Obstructive jaundice is a condition in which there is blockage of the flow of bile out of the liver. This results in redirection of excess bile and its by-products into the blood, and bile excretion from the body is incomplete.
What is the pathophysiology of post-hepatic (obstructive) jaundice?
In post-hepatic jaundice or obstructive jaundice, there is an impediment to the flow of bile due to a partial or complete obstruction of the extrahepatic biliary passage between the liver and duodenum. Obstruction can occur within the biliary ducts themselves or more distal within the pancreas.
What is the goal of the clinical evaluation for jaundice?
The goal of the clinical evaluation is to identify the root cause for jaundice. Fortunately, in most cases, obstructive jaundice can be treated with intravenous fluids, antibiotics and, if necessary, surgical removal of the obstruction. Untreated, obstructive jaundice can lead to serious infection that spreads to other parts of the body.
What are the two types of cholestatic jaundice?
Cholestatic jaundice can be classified into two broad categories: intrahepatic and extrahepatic. Intrahepatic cholestatic jaundice is due to impaired hepatobiliary production and excretion of bile causing bile components to enter the circulation. The concentration of conjugated bilirubin in serum is elevated in cholestatic jaundice.