Jaundice refers to a clinical sign of hyperbilirubinemia (>2.5 mg/dl) which has many causes. It is often a clue to a diagnosis. It can be largely divided into two types:
- non-obstructive, i.e. pre-hepatic and hepatic causes
- obstructive, i.e. post-hepatic causes
Imaging has a major role in detecting the obstructive causes.
Jaundice is the yellowing of the skin and/or sclera. Patients may present painless or painful jaundice. Painless jaundice is always very suspicious for an underlying obstructive malignant cause 3.
Categories of causes 3:
- haemolytic anaemia
- mechanical heart valve
- acute hepatitis / acute liver failure
- Gilbert syndrome
post-hepatic (a.k.a. obstructive jaundice)
- benign causes
- malignant causes
Patients presenting with jaundice is a common indication for imaging. Often a specific cause will not be found, and the main role is differentiating between non-obstructive and obstructive jaundice. In the latter, extrahepatic and/or intrahepatic bile duct dilatation can be expected, depending on the level of obstruction.
- 1. Shanser JD, Korobkin M, Goldberg HI et-al. Computed tomographic diagnosis of obstructive jaundice in the absence of intrahepatic ductal dilatation. AJR Am J Roentgenol. 1978;131 (3): 389-92. doi:10.2214/ajr.131.3.389 - Pubmed citation
- 2. Weinstein DP, Weinstein BJ, Brodmerkel GJ. Ultrasonography of biliary tract dilatation without jaundice. AJR Am J Roentgenol. 1979;132 (5): 729-34. doi:10.2214/ajr.132.5.729 - Pubmed citation
- 3. Fundamentals of surgical practice. Cambridge University Press. ISBN:0521677068. Read it at Google Books - Find it at Amazon