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Jaundice can be due to pre-hepatic, hepatic or post hepatic disorders. Diagnostic investigations start with performing haematology and serum biochemistry. In cases of haemolytic anaemia causing jaundice, the anaemia will be severe and regenerative. S
Serum biochemistry should be performed and will reveal increased bilirubin in jaundiced cases and the degree of hyperbilirubinaemia does not differentiate between hepatic and post hepatic causes.
Neutrophilic cholangitis and lymphocytic cholangitis are the most common hepatic causes of jaundice. In neutrophilic cholangitis, the predominate histopathological feature is a neutrophilic infiltrate within the bile duct lumen and/or epithelium. Lymphocytic The predominant histopathological feature is lymphocytic infiltration.
Abdominal ultrasound is essential in determining hepatic versus post hepatic causes of jaundice. In post hepatic causes of jaundice, biliary tract distension is a key feature. If there is complete obstruction then surgery is indicated. Medical therapy is instituted for partial obstructions.
