Suggested Procedures in Jaundice with Intrahepatic 'Cholestatic Picture'
- Causes of 'Intra-hepatic' group of cholestatic jaundice: - i.e. biliary ducts not obstructed on imaging
- pregnancy (2nd / 3rd trimester)
- sepsis (e.g. in intensive care situation) may mimic cholestasis
- benign post-operative jaundice also seen in ICU after long surgery and relative hypoxia of liver
- Hodgkin's disease may be a cause, even when porta hepatis normal on imaging
- benign recurrent cholestasis is uncommon
- Classification based on apparent site of Intra-hepatic Cholestasis.
A. Viral hepatitis ; B. Alcoholic hepatitis ; C. Chronic active hepatitis
A. Drugs (flucloxacillin; clavulanic acid; 17-alkylated steroids, phenothiazines) ; B. Sepsis
C. Toxic shock syndrome ; D. Postoperative ; E. Total parenteral nutrition
F. Neoplasms (Hodgkin's disease, lymphoma)
G. Sickle cell anaemia ; H. Amyloidosis
A. Sarcoidosis ; B. Primary Biliary cirrhosis
A. Intrahepatic biliary atresia ; B. Primary sclerosing cholangitis (PSC)
C. Caroli's disease ; D. Cholangiocarcinoma
V. Recurrent Cholestasis
A. Benign recurrent intrahepatic cholestasis ; B. Recurrent jaundice of pregnancy
C. Dubin-Johnson syndrome (familial failure of excretion of conjugated bilirubin).
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