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Obstructive jaundice (defined as due to a block in the pathway between the site of conjugation of bile in the liver cells and the entry of bile into the duodenum through the ampulla)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Extrahepatic cholestasis results from the mechanical obstruction to large bile ducts outside the liver or within the porta hepatis.

The liver is enlarged and the intra-hepatic bile ducts widely dilated. The bile ducts proliferate in the portal zones. Infection of the bile above the obstruction leads to cholangitis; the ducts contain pus and may be surrounded by small abscesses.

The biochemical derangement is reinforced by clinical symptoms and signs:

  • pale stool - no bilirubin reaching gastrointestinal tract for conversion to stercobilin
  • dark orange urine - reflux of conjugated bilirubin into blood and excretion in urine

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