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| | __NOTOC__ |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| | | {{Cholestasis}} |
| {{CMG}} | | {{CMG}} |
| {{Editor Help}}
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| {{Infobox_Disease | | | {{SK}} Cholestatic jaundice; conjugated hyperbilirubinaemia; obstruction of bile duct; obstructive jaundice; acholuria; biliary stasis |
| Name = {{PAGENAME}} |
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| Image = |
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| Caption = |
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| DiseasesDB = 9121 |
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| ICD10 = {{ICD10|K|71|0|k|70}}, {{ICD10|K|83|1|k|80}} |
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| ICD9 = {{ICD9|576.2}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = ped |
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| eMedicineTopic = 383 |
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| MeshID = D002779 |
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| }}
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| {{Cholestasis}}
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| ==[[Cholestasis overview|Overview]]==
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| ==[[Cholestasis overview|Overview]]== | | ==[[Cholestasis overview|Overview]]== |
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| ==[[Cholestasis historical perspective|Historical Perspective]]==
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| ==[[Cholestasis pathophysiology|Pathophysiology]]== | | ==[[Cholestasis pathophysiology|Pathophysiology]]== |
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| ==[[Cholestasis epidemiology and demographics|Epidemiology & Demographics]]==
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| ==[[Cholestasis risk factors|Risk Factors]]==
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| ==[[Cholestasis screening|Screening]]==
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| ==[[Cholestasis causes|Causes]]== | | ==[[Cholestasis causes|Causes]]== |
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| ==[[Cholestasis differential diagnosis|Differentiating Cholestasis]]== | | ==[[Cholestasis differential diagnosis|Differentiating Cholestasis from other Diseases]]== |
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| ==[[Cholestasis natural history|Complications & Prognosis]]== | | ==[[Cholestasis risk factors|Risk Factors]]== |
| | ==[[Cholestasis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ==Diagnosis== | | ==Diagnosis== |
| [[Cholestasis history and symptoms|History and Symptoms]] | [[Cholestasis physical examination|Physical Examination]] | [[Cholestasis staging|Staging]] | [[Cholestasis laboratory tests|Laboratory tests]] | [[Cholestasis electrocardiogram|Electrocardiogram]] | [[Cholestasis x ray|X Rays]] | [[Cholestasis CT|CT]] | [[Cholestasis MRI|MRI]] [[Cholestasis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Cholestasis other imaging findings|Other images]] | [[Cholestasis other diagnostic studies|Alternative diagnostics]] | | [[Cholestasis history and symptoms|History and Symptoms]] | [[Cholestasis physical examination|Physical Examination]] | [[Cholestasis laboratory findings|Laboratory findings]] | [[Cholestasis CT|CT]] | [[Cholestasis MRI|MRI]] | [[Cholestasis ultrasound|Ultrasound]] | [[Cholestasis other imaging findings|Other Imaging Findings]] | [[Cholestasis other diagnostic studies|Other Diagnostic Studies]] |
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| ==Treatment== | | ==Treatment== |
| [[Cholestasis medical therapy|Medical therapy]] | [[Cholestasis surgery|Surgical options]] | [[Cholestasis primary prevention|Primary prevention]] | [[Cholestasis secondary prevention|Secondary prevention]] | [[Cholestasis cost-effectiveness of therapy|Financial costs]] | [[Cholestasis future or investigational therapies|Future therapies]] | | [[Cholestasis medical therapy|Medical Therapy]] | [[Cholestasis surgery|Surgery]] | [[Cholestasis prevention|Prevention]] | [[Cholestasis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Cholestasis future or investigational therapies|Future or Investigational Therapies]] |
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| ==Etiology==
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| * [[Gallstone]]s
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| * [[Abdominal mass]] (e.g. [[cancer]])
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| * [[Primary sclerosing cholangitis]], secondary to [[inflammatory bowel disease]]
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| * [[Primary biliary cirrhosis]], secondary to autoimmune disorders
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| * Congenital anomalies of the bilary tract
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| * Biliary [[Physical trauma|trauma]]
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| * Some drugs, (e.g. [[Flucloxacillin]] and [[Erythromycin]])
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| * In children, [[biliary atresia]] and other pediatric liver diseases
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| * [[Pregnancy]], referred to as [[Intrahepatic Cholestasis of Pregnancy]], or Obstetric Cholestasis
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| ==Histopathology==
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| Under a [[microscope]], the individual hepatocytes will have a brownish-green stippled appearance within the [[cytoplasm]], representing bile that cannot get out of the cell. Canalicular bile plugs between individual hepatocytes or within bile ducts may also be seen, representing bile that has been excreted from the hepatocytes but cannot go any further due to the obstruction. When these plugs occur within the bile duct, sufficient pressure (caused by bile accumulation) can cause them to rupture, spilling bile into the surrounding [[biological tissue|tissue]], causing hepatic [[necrosis]]. These areas are known as bile lakes, and are typically seen only with extra-hepatic obstruction.
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| ==Symptoms==
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| * Pale stools,
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| * dark urine,
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| * itchiness ([[pruritus]]) and
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| * [[jaundice]].
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| [[Bile]] is secreted by the liver to aid in the [[digestion]] of [[fats]]. Drugs such as [[gold salts]],[[nitrofurantoin]], [[anabolic steroids]], chlorpromazine, prochlorperazine, sulindac, cimetidine, [[erythromycin]], can cause cholestasis and may result in damage to the [[liver]].
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| == Differential Diagnosis of Cholestasis == | | ==Case Studies== |
| * After liver transplantation
| | [[Cholestasis case study one|Case #1]] |
| * After ulcer surgery
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| * [[Alagille Syndrome]]
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| * [[Alcoholic Hepatitis]]
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| * [[Alpha-1 Antitrypsin Deficiency]]
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| * [[Amebiasis]]
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| * [[Amyloidosis]]
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| * Bile duct carcinoma
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| * Bile duct calculi
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| * Bile duct cysts
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| * [[Biliary atresia]]
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| * [[Budd-Chiari Syndrome]]
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| * [[Bylers Syndrome]]
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| * Carbonic anhydrase inhibitors
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| * [[Caroli's Syndrome]]
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| * Cholangiocellular carcinoma
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| * Cholecystectomy
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| * Choledochotomy with T-tube drainage
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| * Chronic active hepatitis
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| * [[Cryptosporidiosis]]
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| * [[Cystic Fibrosis]]
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| * Drugs
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| * [[Dubin-Johnson Syndrome]]
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| * Duodenal abscess
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| * [[Echinococcosis]]
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| * Familiar progressive cholestasis
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| * [[Hemochromatosis]]
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| * [[Hydatid cyst]]
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| * Idiopathic postoperative jaundice
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| * Idiopathic relapsing cholestasis
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| * Impaired bile acid synthesis
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| * Intermittent cholestasis
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| * Ischemia of other origin
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| * [[Leptospirosis]]
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| * [[Liver abscess]]
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| * [[Liver Cancer]]
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| * Liver cysts
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| * Liver metastases
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| * [[Lymphoma]]
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| * [[Mirizzi's Syndrome]]
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| * Neoplasm
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| * [[Pancreatic Cancer]]
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| * Pancreatic cyst
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| * [[Pancreatitis]]
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| * Pancreatoduodenectomy
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| * Papillary carcinoma
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| * Parasites
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| * Parasitosis
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| * Pericholedochal infection
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| * Postoperative
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| * [[Pregnancy]] cholestasis
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| * Primary and secondary [[sclerosing cholangitis]]
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| * [[Primary biliary cirrhosis]]
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| * [[Primary sclerosing cholangitis]]
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| * Rare congenital causes
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| * Relapsing cholangitis
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| * [[Reye's Syndrome]]
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| * [[Sarcoidosis]]
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| * [[Sepsis]]
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| * [[Sickle Cell Anemia]]
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| * Stenosis of the bile papilla
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| * Stricture
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| * Total parenteral nutrition
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| * Toxic, allergic
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| * [[Toxic Shock Syndrome]]
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| * [[Viral Hepatitis]]
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| * [[Wilson's Disease]]
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| * [[Zieve's Syndrome]]
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| ==See also== | | ==Related Chapters== |
| *[[Jaundice]] | | *[[Jaundice]] |
| *[[Liver function tests]] | | *[[Liver function tests]] |
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| *[[Intrahepatic Cholestasis of Pregnancy]] | | *[[Intrahepatic Cholestasis of Pregnancy]] |
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| ==External links==
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| *[http://www.nlm.nih.gov/medlineplus/ency/article/000218.htm Drug-induced cholestasis] - medlineplus.org
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| *[http://www.liverfamilies.net Liver Families] = pediatric liver support group
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| *[http://www.itchymoms.com/ Itchy Moms] - information about Obstetric Cholestasis / Cholestasis of Pregnancy
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| *[http://www.ocsupport.org.uk/ OC Support website] - OC Support website: information about Obstetric Cholestasis, research, support, shared experiences, discussion forum.
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| {{SIB}}
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| {{Gastroenterology}} | | {{Gastroenterology}} |
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| [[Category:Gastroenterology]] | | [[Category:Gastroenterology]] |
| [[Category:Hepatology]] | | [[Category:Hepatology]] |
| | [[Category:Obstetrics]] |
| | [[Category:Disease]] |
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| [[pl:Cholestaza]] | | [[pl:Cholestaza]] |