Haematology:
- full blood count - may be anaemic due to malignancy
- raised white count may indicate cholangitis or underlying malignancy
- leucopaenia may occur in viral hepatitis
- reticulocytosis indicates pre-hepatic jaundice
- prothrombin time - prolonged in chronic liver disease; will return to normal in cholestasis following parenteral vitamin K, 10 mg
Biochemistry:
- serum transaminases - increased in hepatic jaundice and to a lesser degree, in extrahepatic jaundice
- serum alkaline phosphatase - raised in extra-hepatic jaundice; hepatic origin confirmed by concomitant rise in gamma glutamyl transferase
- serum bilirubin - confirms jaundice; used to monitor progress
- serum albumin and globulin - little change in acute jaundice; albumin decreased and globulin increased in chronic hepatic jaundice
Urinalysis
Stools:
- pale stools in cholestasis
- occult blood - suggests carcinoma
Abdominal ultrasound - assesses bile duct dilatation, liver size, liver metastases, portal blood flow, ascites, lymphadenopathy
Chest x-ray - to show primary or secondary tumours, and any irregularity or elevation of the right diaphragm due to enlarged or nodular liver