JAUNDICE

Predominance of direct (conjugated) bilirubin

• Extrahepatic obstruction:

• Common duct abnormalities:  calculi, neoplasm, stricture, cyst,
  sclerosing cholangitis.

• Metastatic carcinoma.

• Pancreatic carcinoma, pseudocyst.

• Ampullary carcinoma.
  Hepatocellular disease: hepatitis, cirrhosis.

• Drugs: estrogens, phenothiazines, captopril, methyltestosterone, labetalol. Cholestatic jaundice of pregnancy.

• Hereditary disorders: Dubin-Johnson syndrome, Rotor's syndrome. Recurrent benign intrahepatic cholestasis.

 

Predominance of indirect (unconjugated) bilirubin

• Hemolysis: hereditary and acquired hemolytic anemias.

• Inefficient marrow production.

• Impaired hepatic conjugation: chloramphenicol.

• Neonatal jaundice.

• Hereditary disorders: Gilbert's syndrome, Crigler-Najjar syndrome.