Obstructive Jaundice

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Introduction

What is obstructive jaundice?

Obstructive jaundice is a condition in which there is blockage of the flow of bile out of the liver. This results in redirection of excess bile and its by-products into the blood, and bile excretion from the body is incomplete. Bile contains many by-products, one of which is bilirubin, a pigment derived from dead red blood cells. Bilirubin is yellow, and this gives the characteristic yellow appearance of jaundice in the skin, eyes, and mucous membranes. Symptoms of obstructive jaundice include yellow eyes and skin, abdominal pain, and fever.

Any type of obstruction that blocks the flow of bile from the liver can cause obstructive jaundice. Most commonly, gallstones create the blockage. Other causes of obstruction include inflammation, tumors, trauma, pancreatic cancer, narrowing of the bile ducts, and structural abnormalities present at birth.

The signs and symptoms of obstructive jaundice differ depending on the completeness of the blockage, and the disease course varies among individuals. Some people with obstructive jaundice may have no symptoms initially, but if the condition persists, they may have severe abdominal pain, fever, nausea, and vomiting. Complete blockage may also occur, posing a risk of infection leading to liver and gallbladder damage. 

The goal of the clinical evaluation is to identify the root cause for jaundice. Fortunately, in most cases, obstructive jaundice can be treated with intravenous fluids, antibiotics and, if necessary, surgical removal of the obstruction.

Untreated, obstructive jaundice can lead to serious infection that spreads to other parts of the body. Seek immediate medical care (call 911) for serious symptoms such as high fever (higher than 101 degrees Fahrenheit), severe abdominal pain, abdominal swelling, and nausea with or without vomiting.

Seek prompt medical care if you are being treated for obstructive jaundice but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of obstructive jaundice?

Obstructive jaundice can cause many different types of symptoms, which vary in intensity among individuals.

Common symptoms of obstructive jaundice

Obstructive jaundice can cause any of the following symptoms, and at times, any of these symptoms can be severe:

Serious symptoms that might indicate a life-threatening condition

In some cases, obstructive jaundice can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Abdominal swelling, distension and bloating

  • High fever (higher than 101 degrees Fahrenheit)

  • Nausea with or without vomiting

  • Severe abdominal pain

Causes

What causes obstructive jaundice?

Obstructive jaundice is a condition in which there is a blockage of the flow of bile out of the liver. This results in redirection of excess bile and its by-products into the blood, and bile excretion from the body is incomplete. Bilirubin, a component of bile, is yellow, which gives the characteristic yellow appearance of jaundice in the skin, eyes, and mucous membranes.

The most common cause of obstructive jaundice is the presence of gallstones (cholelithiasis). Other causes of obstructive jaundice are tumors, trauma, cysts, and inflammation in the bile ducts.

Causes of obstructive jaundice

Obstructive jaundice is caused by conditions that block the normal flow of bile from the liver into the intestines including:

  • Biliary stricture (narrowing of the bile duct)

  • Cancer of the gallbladder or pancreas

  • Cholangitis (infection or inflammation of the common bile duct)

  • Cholelithiasis (gallstones)

  • Congenital structural defects

  • Cysts of the bile duct

  • Lymph node enlargement

  • Pancreatitis

  • Parasitic infection

  • Trauma, including surgical complications

What are the risk factors for obstructive jaundice?

A number of factors increase your risk of developing obstructive jaundice. Not all people with risk factors will get obstructive jaundice. Risk factors for obstructive jaundice include:

  • Abdominal injury

  • Gallstones

  • Pancreatic cancer

  • Tumors in the area of the common bile duct

Treatments

How is obstructive jaundice treated?

Your health care professional can develop a treatment plan tailored to your needs. It is important to precisely follow your treatment plan for obstructive jaundice to help minimize your symptoms and decrease the chance of your symptoms recurring over time.

To determine if you have obstructive jaundice, your health care provider may ask you to provide blood samples and undergo diagnostic tests.

Treatment options for obstructive jaundice

Treatment options for obstructive jaundice depend on the exact cause of the jaundice and on the severity of the disease. Examples include:

  • Antibiotic therapy (if indicated for infection)

  • Endoscopic retrograde cholangiopancreatography (ERCP), an imaging procedure that allows treatment of some bile duct problems, including removal of gallstones that are causing obstruction

  • Intravenous fluids and pain medications

  • Nutritional support

  • Surgery or other procedures to repair anatomical defects or create alternative pathways for the flow of bile

  • Transplantation of the liver (if all other methods are unsuccessful and all of the liver is damaged)

  • Treatment for cancer, if present, which may include surgery, chemotherapy, or radiation therapy

What are the potential complications of obstructive jaundice?

You can help minimize your risk of serious complications by following the treatment plan that you and your health care professional design specifically for you. Complications of obstructive jaundice include:

  • Adverse effects of obstructive jaundice treatment

  • Cirrhosis (scarring of the liver)

  • Coagulopathy (a blood clotting disorder)

  • Digestive problems

  • Liver failure

  • Malabsorption syndrome (a disorder that interferes with the absorption of nutrients from food)

  • Spread of cancer

  • Spread of infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. Jaundice. MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&query=Jaundice&x=0&y=....
  2. Jaundice. Lab Tests Online. http://www.labtestsonline.org/understanding/conditions/jaundice.html.
  3. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.
  4. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
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