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Posthepatic jaundice (obstructive jaundice) is caused by a blockage of bile ducts that transport bile containing conjugated bilirubin out of the liver for excretion. [29] This is a list of conditions that can cause posthepatic jaundice: Choledocholithiasis (common bile duct gallstones). It is the most common cause of obstructive jaundice.
Treatment of the condition is specific to the cause of hemolysis, but intense phototherapy and exchange transfusion can be used to help the patient excrete accumulated bilirubin. [11] Complications related to hemolytic jaundice include hyperbilirubinemia and chronic bilirubin encephalopathy, which may be deadly without proper treatment. [12] [13]
Mild jaundice may appear under conditions of exertion, stress, fasting, and infections, but the condition is otherwise usually asymptomatic. [7] [8] Severe cases are seen by yellowing of the skin tone and yellowing of the conjunctiva in the eye. [9] Gilbert syndrome has been reported to contribute to an accelerated onset of neonatal jaundice.
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Hyperbilirubinemia can cause a yellowing of the skin called jaundice depending on the level of bilirubin in the blood. [3] Additional symptoms of hyperbilirubinemia include darker urine (bilirubinuria) due to increased unconjugated bilirubin removed from the body in urine.
This reaction is highly useful in understanding the nature of jaundice. This was pioneered by the Dutch physician, Abraham Albert Hijmans van den Bergh (1869–1943) of Utrecht. This test helps to identify the type of jaundice. The serum of the patient is mixed with diazo reagent. If a red colour develops immediately it is called a direct positive.
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]
Most (>95%) infants with biliary atresia will undergo an operation designed to retain and salvage the native liver, restore bile flow, and reduce the level of jaundice. This is known as the Kasai procedure (after Morio Kasai , the Japanese surgeon who first developed the technique) or hepatoportoenterostomy .