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Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. [3] [6] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction. [7]
Physical examination reviews clinical symptoms like degree of jaundice, vital signs and sensations of pain, further followed by urine tests, blood analysis and imaging. [3] [4] The degree of yellowish staining of the conjunctiva and skin in jaundice is proportional to hyperbilirubinemia to some extent. [6]
Rotor syndrome (also known as Rotor type hyperbilirubinemia) [2] is a rare cause of mixed direct (conjugated) and indirect (unconjugated) hyperbilirubinemia, relatively benign, autosomal recessive [3] bilirubin disorder characterized by non-hemolytic jaundice due to the chronic elevation of predominantly conjugated bilirubin.
In both newborns and adults, yellowing of the skin is a marker for jaundice. [27] As most cases of jaundice are observed in newborns, healthcare workers use visual methods to identify the presence of this condition. [29]
A 2024 study suggested that hereditary TTP is underdiagnosed and should be considered in cases of unexplained stroke, neonatal jaundice, and severe pre-eclampsia. [24] The study estimated the global prevalence of hereditary TTP at 40 per million, in contrast to previously reported estimates of 0.5 to 2.0 per million.
Jaundice of the skin or eyes is an important physical finding in biliary obstruction. Jaundice and/or clay-colored stool may raise suspicion of choledocholithiasis or even gallstone pancreatitis. [1] If the above symptoms coincide with fever and chills, the diagnosis of ascending cholangitis may also be considered.
Jaundice may be noticeable in the sclera of the eyes at levels of about 2 to 3 mg/dl (34 to 51 μmol/L), [27] and in the skin at higher levels. [note 1] Jaundice is classified, depending upon whether the bilirubin is free or conjugated to glucuronic acid, into conjugated jaundice or unconjugated jaundice. [citation needed]
The partial external biliary diversion (PEBD) procedure is a surgical approach that diverts bile from the gallbladder externally into an ileostomy bag. [ 7 ] Patients should be supplemented with fat-soluble vitamins, and occasionally medium-chain triglycerides in order to improve growth.