Jaundice: Investigations & Treatment
                     Jaundice: Investigations & 
Treatment
What Is Jaundice?
    Yellowish discoloration of body mainly sclera of eye is jaundice and 
generally indicate liver disease. It occur due to accumulation of bilirubin 
pigment in the body. Bilirubin pigment is formed after destruction of old 
red blood cells in the body and after that it is secreted through bile in to 
stool. Hyperbilirubinemia occur either due to excessive production 
because of excessive hemolysis. It also occur if there is obstruction in the 
passage of bilirubin pigment through liver in to small intestine.
Blood Investigations
      Liver Function Test: Most common blood investigation 
done in jaundice patient. Bilirubin is raised. In case of 
obstructive jaundice conjugated part of bilirubin is raised 
while in hemolysis or other medical cause such as 
hepatitis  unconjugated bilirubin is raised. If the cause is 
hepatitis then enzymes SGOT/SGPT are also raised. Serum 
alkaline phosphate is marker for obstructive jaundice
Most common cause of hepatitis are alcoholic hepatitis, 
Viral hepatitis and steatohepatitis. Most common viral 
infections are Hepatitis A, E, B and C infection. Blood test 
for the presence of these infections should be done in 
case of acute hepatitis
Complete Blood Count
    Total Leucocyte counts is raised in patient with cholangitis. Renal function 
tests should also be done as these patients have dehydration and low 
blood pressure and RFT can be deranged.
Radiological Investigations
      USG Abdomen: The most common first investigation 
done is Ultrasound abdomen. The dilatation of biliary 
channels on ultrasound suggest biliary tract obstruction. 
The level of bile duct dilatations indicate the site of 
obstruction. CBD stones or mass can be visualized on 
ultrasound as cause of obstruction
MRI/MRCP: It is more helpful to delineate biliary 
anatomy before any intervention. There are guidelines 
which recommend EUS in these patients before ERCP
Treatment or Consult a Surgeon
     Gastroenterologist are liver specialist and should be consulted first when 
there is jaundice, as the commonest cause is medical jaundice. Jaundice 
occur when there is excess biliary pigments in our blood; Bile is produced 
in the liver and through the bile duct it reaches to duodenum where its 
main function is fat digestion, The cause of jaundice is Surgical or 
Obstructive when there is obstruction in the bile duct and bile does not 
reach up to duodenum and get accumulated in our blood.  
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      Dr. Amit Jain MBBS, MS – General Surgery MCh – Surgical 
Gastroenterology/G.I. Surgery
      Email : - [email protected]
      Max Super Speciality Hospital Patparganj, Vaishali
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