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Important points in a history concerning jaundice include:

  • duration of illness:
    • short history, preceding nausea, anorexia - suggests hepatitis
    • cholestatic jaundice develops slowly, usually with persistent pruritus
    • pyrexia, fevers, rigors - suggests cholangitis associated with gallstones or biliary stricture

  • family history - congenital hyperbilirubinaemia, hepatitis, gallstones

  • recent community outbreak of jaundice - suggests hepatitis A

  • recent consumption of shellfish - suggests hepatitis A

  • note recent travel to areas where hepatitis is endemic

  • male homosexuality, recent injections - intravenous drug abuse, blood tests, tuberculin testing - increased risk of hepatitis B

  • recent blood or plasma transfusion - increased risk of hepatitis C in developed countries; of hepatitis B in developing countries

  • alcohol consumption - may complain of morning nausea, anorexia, diarrhoea, right upper quadrant pain

  • recent surgery:
    • jaundice following biliary tract surgery may indicate residual calculi
    • may be due to anaesthesia e.g. halothane

  • rarely the patient may complain that everything has a yellow tinge - xanthopsia

Last reviewed 01/2018

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