By ULY CLINIC

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Cholestatic Jaundice

 

Introduction

 

Cholestasis is a pathologic state of reduced bile formation or flow which can be hepatocellular (Intrahepatic), where an impairment of bile formation occurs or ductular (extra hepatic), where impedance to bile flow occurs after it is formed. Intrahepatic causes of cholestasis include viral hepatitis, alcohol, primary biliary cirrhosis, drug toxicity, Hodgkin’s lymphoma and pregnancy. Extrahepatic causes include choledocholithiasis, carcinoma, and ascariasis of the biliary tree.

  

Diagnostic criteria

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• Jaundice, 

• Dark urine, 

• Pale stools, and 

• Generalized body itching/pruritis. PLUS

• Laboratory evidence of elevated serum levels of total bilirubin, direct bilirubin, alkaline phosphatase, gamma-glutamyl transferase, and transaminanses. WITH

• Supporting radiological evidence of dilated intra or extra hepatic biliary radicles. 

 

Pharmacological Treatment

 

Definitive treatment:

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Identify and treat specific cause  Supportive treatment:

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• Cholestyramine (PO) 4–16gm/day 

 

OR

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• Ursodeoxycholic acid (PO) 20–30 mg/kg/day  Surgical intervention is indicated for extra hepatic cholestasis. 

 

Note 

 

Refer cases to the next level of care with adequate expertise and facility for proper evaluation and management of prolonged and unresponsive cholestatic jaundice.    

      

Updated on, 2.11.2020

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References

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1. STG