Jaundice
Pre-hepatic
Hepatic
Impaired conjugation
Good conjugation
Post-Hepatic (Obstruction)
High (above cystic duct opening)
Low
- Haemolysis
Hepatic
Impaired conjugation
- Gilbert's syndrome (reduced activity of UGT)
- Crigler-Najjar Syndrome I/ II (absence/ deficient UGT)
- Hyperthyroidisim
- Neonatal Jaundice
- Liver disease (chronic hepatitis, advanced cirrhosis, Wilson disease)
Good conjugation
- Hepatitis (Viral (usually not Hep C), alcoholic NASH, alcoholic, chronic)
- Primary biliary cirrhosis
- Shock (sepsis, hypoperfusion)
- Drugs/ Toxins
Post-Hepatic (Obstruction)
High (above cystic duct opening)
- Cholangiocarcinoma (Klatskin Tumour)
- GB carcinoma
- Mirizzi's Syndrome I/ II
- Choledochal cysts and Caroli's Syndrome
Low
- Choledocholithiasis
- Head of pancreas tumour/ extrinsic tumour
- Parasites (Ascaris, liver flukes)
- Iatrogenic strictures