JAUNDICE a condition that affects the liver causing the skin and sclera
A57-YEAR-OLD man accompanied by his wife presented with intermittent nausea, right upper quadrant (RUQ) pain, and decreased appetite at the outpatient department (OPD).
Upon asking and examining him, he explains that his stool has become lighter
colour his urine has become tea-coloured and his eyes visualised yellow coloured.
He has no history of diabetes and cholecystectomy. An abdominal ultrasound examination including Liver function test (LFT) was requested immediately, thereafter the abdominal ultrasound results showed choledocholithiasis and cholecystitis with a report concluding obstructive jaundice.
Jaundice is a condition that affects the liver causing the skin and sclera (white part of the eyes) turn yellow due to increased level of bilirubin in the blood.
Bile is fluid secreted by the liver. Bilirubin is a yellow-colored pigment that remains in the bloodstream after iron is removed from the blood.
Jaundice occurs when there is too much bilirubin in the body system, reabsorbed by the surrounding tissues causing the yellowing of the skin and eyes.
There are three main types of jaundice such as;
1. Hepatocellular jaundice which occur as a result of liver disease including injury.
2. Hemolytic jaundice which develop as a result of accelerated breakdown of red blood cells, leading to an increase in production of bilirubin.
3. Obstructive jaundice occurs 2 as a result of an obstruction in the bile duct by either stones or tumours 2 which prevent bilirubin from leaving the liver.
CAUSES
Jaundice can be caused by underlying conditions that either causes the production of too much bilirubin or prevents the liver from getting rid of it. Both of these result in leaking bilirubin in the body tissue. Some of the underlying conditions are as follows;
Gilbert’s syndrome: This is an inherited condition that impairs the ability of enzymes to process the excretion of bile.
Inflammation of the bile duct: This can prevent the secretion of bile and removal of bilirubin, causing jaundice.
Acute inflammation of the liver caused by viruses such as Epstein-Barr virus infection, hepatitis (A, B & C) etc.: This may impair the ability of the liver to conjugate and secrete bilirubin, resulting in a buildup.
Obstruction of the bile duct caused by stones, tumors etc.: This prevents the liver from disposing of bilirubin. Hemolytic anemia: this is when the blood cells are destroyed and removed from the bloodstream before their normal lifespan is over.
Signs and symptoms Jaundice symptoms may include yellowing of the skin and eyes, dark coloured, clay-coloured stool, itch
iness, fever, fatigue, vomiting, abdominal pain and weight loss.