Jaundice: Investigations & Treatment

What is Jaundice

Yellowish discoloration of body mainly sclera of eye is jaundice and generally indicate liver disease. It occur due to accumulation of bilirubin pigment in the body. Bilirubin pigment is formed after destruction of old red blood cells in the body and after that it is secreted through bile in to stool. Hyperbilirubinemia occur either due to excessive production because of excessive hemolysis. It also occur if there is obstruction in the passage of bilirubin pigment through liver in to small intestine

Blood Investigations

The most common blood investigation done is Liver Function Test. Bilirubin is raised. In case of obstructive jaundice conjugated part of bilirubin is raised while in hemolysis or other medical cause unconjugated bilirubin is raised. If the cause is hepatitis then enzymes SGOT/SGPT are also raised. Serum alkaline phosphate is marker for obstructive jaundice
Unconjugated bilirubin is raised in Hepatitis patients. Most common cause of hepatitis are alcoholic hepatitis, Viral hepatitis and steatohepatitis. Most common viral infections which cause hepatitis are Hepatitis A, E, B and C infection. Blood test for the presence of these infections should be done in case of acute hepatitis
Total Leucocyte counts is raised in patient with cholangitis. Renal function tests should be done as these patients have dehydration and low blood pressure and RFT can be deranged

Radiological Investigations

The most common first investigation done is Ultrasound abdomen. The dilatation of biliary channels on ultrasound suggest biliary tract obstruction. The level of bile duct dilatations indicate the site of obstruction. CBD stones or mass can be visualized on ultrasound as cause of obstruction
MRI/MRCP is more helpful to delineate biliary anatomy before any intervention There are guidelines which recommend EUS in these patients before ERCP


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