SPOTTERS MEDICINE
JAUNDICE
🔹 Definition:
Jaundice is
the yellowish discoloration of skin, sclera, and mucous membranes due to
elevated bilirubin levels (>2–2.5 mg/dL) in the blood.
🔹 Types of Jaundice:
1.
Pre-hepatic (Hemolytic):
o Excess breakdown of RBCs
o ↑ Unconjugated bilirubin
o Example: Hemolytic anemia, malaria
2.
Hepatic (Hepatocellular):
o Impaired liver function (damage to
hepatocytes)
o Mixed conjugated and unconjugated
bilirubin
o Example: Viral hepatitis, alcoholic
hepatitis, cirrhosis
3.
Post-hepatic (Obstructive/Cholestatic):
o Obstruction of bile flow
o ↑ Conjugated bilirubin
o Example: Gallstones, pancreatic
cancer, biliary atresia
🔹 Causes of Jaundice:
- Neonatal jaundice (physiological, hemolytic,
breast milk jaundice)
- Hepatitis (A, B, C, E)
- Alcoholic liver disease, NAFLD
- Gallstones, choledocholithiasis
- Hemolytic disorders (e.g.,
thalassemia)
- Drugs/toxins (e.g., paracetamol overdose)
🔹 Clinical Features:
- Yellow discoloration of sclera,
skin, nails
- Dark urine (conjugated hyperbilirubinemia)
- Pale (clay-colored) stools (obstructive jaundice)
- Pruritus in obstructive jaundice
- Fatigue, anorexia, nausea
- RUQ tenderness or hepatomegaly
(in hepatic causes)
🔹 Investigations:
- Serum bilirubin (total, direct, indirect)
- Liver function tests – ALT, AST, ALP, GGT
- Hemogram – to detect hemolysis
- Ultrasound abdomen – to detect obstruction
- Viral markers (HBsAg, anti-HCV)
- Coagulation profile (PT/INR)
🔹 Treatment:
- Depends on cause:
- Antivirals for hepatitis
- Cholecystectomy for gallstones
- Chelation or blood transfusion
for hemolysis
- Supportive care: fluids,
nutrition, liver-protective drugs
- Avoid hepatotoxic drugs
🔹 Complications:
- Hepatic encephalopathy
- Bleeding tendencies (↓ clotting factors)
- Cirrhosis and portal
hypertension
- Acute liver failure
🔹 Prognosis:
- Excellent in transient or
infectious jaundice
- Poor in malignant or
end-stage liver disease
- Requires timely diagnosis and
management
DR.C.GANESAN M.D.
PROFESSOR OF MEDICINE
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