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Gallstones are more common in pregnant women due to elevated hormones and cholesterol levels, which block the bile duct and obstruct bilirubin excretion. [11] Besides, preeclampsia and eclampsia , denoted by high blood pressure , are linked to hyperbilirubinemia through damaging highly perfused organs , particularly liver and kidneys . [ 12 ]
Alanine aminotransferase and aspartate transaminase are usually suggestive of liver disease whereas elevation of bilirubin and alkaline phosphatase suggests common bile duct obstruction. [12] Pancreatitis should be considered if the lipase value is elevated; gallstone disease is the major cause of pancreatitis. [citation needed]
If one or more gallstones block the bile ducts and cause bilirubin to leak into the bloodstream and surrounding tissue, jaundice and itching may also occur. In this case, liver enzyme levels are likely to be raised. [16] Often, gallbladder attacks occur after eating a heavy meal. Attacks are most common in the evening or at night. [17]
Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (CBD) (thus choledocho-+ lithiasis). This condition can cause jaundice and liver cell damage. Treatments include choledocholithotomy and endoscopic retrograde cholangiopancreatography (ERCP).
Gallstones form when the bile is saturated, usually with either cholesterol or bilirubin. [20] Most gallstones do not cause symptoms, with stones either remaining in the gallbladder or passed along the biliary system. [21] When symptoms occur, severe "colicky" pain in the upper right quadrant of the abdomen is often felt. [20]
Treatment depends on the type and cause of the hemolytic anemia. [2] Symptoms of hemolytic anemia are similar to other forms of anemia (fatigue and shortness of breath), but in addition, the breakdown of red cells leads to jaundice and increases the risk of particular long-term complications, such as gallstones [4] and pulmonary hypertension. [5]
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]