Cholestasis

Cholestasis: Description, Causes and Risk Factors:ICD 9: 576.2.Cholestasis is defined as a decrease in bile flow due to impaired secretion by hepatocytes or to obstruction of bile flow through intra-or extrahepatic bile ducts.Types:Intrahepatic.
  • Extrahepatic.
  • Drug-induced.
Causes and Risk Factors:Intrahepatic occurs inside the liver. Causes include:Viral hepatitis.
  • Alcoholic liver disease.
  • Sepsis.
  • Tuberculosis.
  • Bacterial abscess in the liver.
  • Being fed through a vein (IV).
  • Amyloidosis.
  • Lymphoma.
  • Pregnancy.
  • Primary biliary cirrhosis.
  • Primary sclerosing cholangitis.
  • Sarcoidosis.
Extrahepatic cholestasis occurs outside the liver. Causes included:Narrowing of the bile duct.Cholestasis 
  • Stones in the common bile duct.
  • Pancreatitis.
  • Bile duct tumors.
  • Cysts.
  • Pancreatic tumor or pseudocyst.
  • Pressure on an organ due to a nearby mass or tumor.
  • Primary sclerosing cholangitis.
Drug-induced cholestasis is caused by certain drugs that can slow or stop the flow of bile from the liver to the gallbladder and gut, which may damage the liver. Drugs that can possibly induce it include birth control pills, anabolic steroids, the penicillin family of drugs, etc.Symptoms:Signs:Dark urine.
  • Inability to digest certain foods.
  • Yellow skin or eyes.
  • Nausea and vomiting.
  • Itching.
Complications: In some more severe cases, the liver damage is permanent.Diagnosis:Differential diagnosis: Biliary atresia, choledochalcysts, gallstones, Alagillesyndrome, neonatal sclerosingcholangitis, cystic fibrosis.Blood tests may show higher than normal levels of bilirubin and alkaline phosphatase.Imaging equipments allow doctors to see your liver and bile ducts and determine exactly where within your liver the problem located. Imaging tests include:CT scan of the abdomen.
  • MRI of the abdomen.
  • Ultrasound of the abdomen.
  • ERCP (Endoscopic retrograde cholangiopancreatography).
Treatment:Treatment is based on the underlying causes.Extrahepatic cholestasis happens outside of the liver, and can occur when there are tumors, stones or cysts blocking the flow of bile. Removing the offending structure is in order for this type of cholestasis. Diverticulitis is another cause of extrahepatic cholestasis, and is usually treated with antibiotic medications or, in some cases, surgery. If you have intrahepatic cholestasis, your doctor will discuss the appropriate treatment for the underlying condition, as it varies wildly. During the time you are affected by cholestasis, your doctor may prescribe ursodeoxycholic acid to reduce the concentration of bile acids in your body. Corticosteroid creams and medications can be used in most cases to treat the severe itching experienced by many people with this disease.Note:The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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