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Diagnosis

Authoring team

Cholestasis is confirmed by:

  • elevated serum bilirubin - in proportion to duration of cholestasis; returns to normal once cholestasis is relieved
  • raised serum alkaline phosphatase - to more than 3X upper limit of normal;
  • LFTs - aminotransferases mildly raised; raised gamma GT
  • increased urinary bilirubin
  • urinary urinobilinogen is excreted in proportion to amount of bile reaching the duodenum i.e. absence of urinobilinogen indicates complete biliary obstruction

Identification of cause:

  • dilated ducts on ultrasound - percutaneous transhepatic cholangiograpy
  • undilated ducts on ultrasound - endoscopic retrograde cholangio-pancreatography
  • needle biopsy of the liver

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