Jaundice

Types of jaundice:

There are 3 types of jaundice-

1.Hemolytic jaundice: bilirubin level>6mg/dl

Clinical Features:
Mongolian face

On examination:

• Anaemia
• Jaundice
• Hepatosplenomegaly
• Urine color:normal(as bilirubin is uncongugated)

2.Hepatocellular Jaundice:
Cause:
a)Acute liver disease(acute hepatitis)
b)Chronic liver disease

3.Obstructive Jaundice(also called cholestasis)
Cause:

• Intrahepatic
• Extrahepatic

Features:

• Itching
• Steatorrhoea

Causes of intrahepatic cholestasis:

 Transient block of hepatic canaliculi-may produce itching

1. Viral hepatitis
2. Alcohol
3. Drug:Chlorpromazine
4. Chronic hepatitis
5. Cirrhosis of liver
6. Pregnancy
7. Primary biliary cirrhosis
8. Sclerosing cholangitis

Causes of extrahepatic cholestasis:

1. In the lumen:

• Stone
• Round worm

     2.In the wall:

• Stricture
• Primary biliary cirrhosis

     3.Outside the wall:external compression by-

• Carsinoma of the head of the pancreas
• Carcinoma of common bile duct
• metastatic tumour
• Enlarged lymphnode in porta hepatitis
• choledocal cyst

Clinical feature of Hepatocellular jaundice:

If viral hepatitis:anorexia,nausea,vomiting.
If caused by CLD:features of chronic liver disease