Jaundice

• Jaundice is a condition characterized by the yellowing of the skin and eyes due to high levels of bilirubin in the blood.
• It can be caused by a variety of conditions affecting the liver, such as hepatitis, cirrhosis, or bile duct obstruction.
• It indicates an underlying problem with the liver or bile ducts.

Symptoms

• Common symptoms of jaundice include:
  1. Yellowing of the Skin and Eyes: Due to high bilirubin levels.
  2. Fatigue
  3. Abdominal Pain
  4. Nausea and Vomiting
  5. Dark Urine
  6. Pale Stools

Types of Jaundice

• It is classified into three main types based on its underlying cause:

  1. Hemolytic Jaundice

     • Cause: Excessive breakdown of red blood cells.
     • Mechanism: The rapid destruction of red blood cells leads to an increased production of bilirubin, exceeding the liver’s capacity to conjugate and excrete it.

  2. Hepatocellular Jaundice

     • Cause: Liver dysfunction or disease (e.g., hepatitis, cirrhosis).
     • Mechanism: Damaged liver cells (hepatocytes) are unable to properly conjugate and excrete bilirubin.

  3. Obstructive Jaundice

     • Cause: Blockage in the bile duct system (e.g., gallstones, tumors).
     • Mechanism: Obstruction prevents bile (and thus bilirubin) from being excreted into the intestines, leading to accumulation in the blood.

Etiology

1. The underlying causes are grouped into three categories:

   1. Pre-hepatic (Hemolytic)

      • Conditions: Hemolytic anemia, sickle cell disease.
      • Effect: Increased red blood cell breakdown elevates bilirubin production.

   2. Hepatic

      • Conditions: Hepatitis, cirrhosis, liver cancer.
      • Effect: Liver diseases impair the liver’s ability to process and excrete bilirubin.

   3. Post-hepatic (Obstructive)

      • Conditions: Gallstones, pancreatic cancer.
      • Effect: Obstruction of bile ducts prevents bilirubin excretion.

Pathogenesis of Jaundice

• The development involves different mechanisms depending on the type:

  1. Pre-hepatic 

     • Increased Bilirubin Production: Excessive hemolysis overwhelms the liver’s ability to conjugate bilirubin.
     • Result: Unconjugated (indirect) bilirubin accumulates in the blood.

  2. Hepatocellular 

     • Impaired Liver Function: Damaged hepatocytes cannot effectively conjugate or excrete bilirubin.
     • Result: Both unconjugated and conjugated bilirubin levels may increase.

  3. Post-hepatic

     • Bile Flow Obstruction: Physical blockage prevents bile from reaching the intestines.
     • Result: Conjugated (direct) bilirubin accumulates in the bloodstream.

Treatment

• Treatment depends on the underlying cause:
  1. Hemolytic Jaundice: Treating the underlying cause of increased red blood cell breakdown, such as blood transfusions or medication.
  2. Hepatocellular Jaundice: Addressing liver dysfunction, such as antiviral medications for hepatitis, or liver transplant in severe cases.
  3. Obstructive Jaundice: Removing the obstruction, such as surgery for gallstones or stenting for bile duct blockages.

Thank you for reading from Firsthope's notes, don't forget to check YouTube videos!