clinical features

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Amongst the most prominent signs of cholestasis, jaundice develops slowly and may be preceded by pruritus for some time. Later, the skin may become greenish.

General signs of cholestasis may include:

  • xanthomas: palmar creases, below the breast, on the neck. They indicate raised serum cholesterol of several months. Xanthomas on the tendon sheaths are uncommonly associated with cholestasis.
  • xanthelasma on the eyelids
  • scratch marks: excoriation
  • finger clubbing
  • loose, pale, bulky, offensive stools
  • dark orange urine

In addition, extrahepatic cholestasis may be present with:

  • pain, due to gallbladder disease, malignancy, or stretching of the liver capsule
  • fever, due to ascending cholangitis
  • palpable and / or tender gallbladder
  • enlarged liver, usually smooth

Last reviewed 01/2018