Jaundice of intrahepatic cholestatic origin
Ictericia de origen colestásico intrahepatico
Abstract
Jaundice is a clinical sign that in all age groups, indicates the presence of a pathology either in the hepatobiliary sphere or not. It is observed when serum bilirubin levels increase, in conjugated or unconjugated form. The medical history allows a fairly accurate evaluation of jaundice and includes the performance of laboratory tests in which total and fractionated bilirubin, hematology, alanine transaminase - ALT, aspartate transaminase - AST, alkaline phosphatase, γ-glutamyltransferase, time of prothrombin and / or international. normalized ratio, serum proteogram (1-3). Imaging studies can identify pathologies in the liver parenchyma and / or the bile ducts. The unconjugated or indirect hyperbilirubinemia raises suspicion in hemolytic processes, in Gilbert's syndrome and conjugated or direct hyperbilirubinemia, in hepatocellular damage, such as viral hepatitis, due to Alcohol Use Disorder (AUD), cholestatic disorders, such as choledocholithiasis and neoplasms in the confluent biliopancreatic. Cholestasis is an acute or chronic hepatobiliary disorder, in which the synthesis, secretion or flow of bile is altered. Cholestasis can affect up to 10-20% of the general population.1 When the etiology is benign, which represents the highest percentage of cases, it is not associated with high morbidity and mortality, when it is prolonged and severe, it can progress Hepatic fibrosis, cirrhosis, hepatocellular carcinoma or cholangiocarcinoma and death can occur, all depending on the etiology as will be explained later.
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References
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