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extrahepatic cholestasis

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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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