Jaundice

CLINICAL DIAGNOSTIC MANUAL

Jaundice is a clinical condition characterised by the yellowish discolouration of the skin, mucous membranes, and sclerae of the eyes due to the accumulation of bilirubin in the tissues. This accumulation can result from various disorders affecting the production, metabolism, excretion, and recycling of bilirubin. Jaundice can be classified as prehepatic, hepatic, or posthepatic (obstructive), depending on the location of the problem within bilirubin metabolism. Identifying the underlying cause is crucial to providing appropriate treatment and preventing complications.

Pathology	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Carotenemia	Yellowish discolouration of the skin, especially on the palms and soles, without affecting the sclerae	History of high intake of carotene-rich foods	Dietary history, physical examination, blood carotene levels
Prehepatic jaundice	Yellowish discolouration of the skin and sclerae, anaemia, splenomegaly, fatigue	History of haemolysis, physical examination	Complete blood count, reticulocyte count, haptoglobin, elevated indirect bilirubin
Hepatic jaundice	Yellowish discolouration of the skin and sclerae, fatigue, hepatomegaly, ascites	History of liver disease, physical examination	Liver function tests, liver ultrasound, liver biopsy
Hepatocellular jaundice	Yellowish discolouration of the skin and sclerae, nausea, vomiting, loss of appetite	History of hepatitis or cirrhosis, physical examination	Liver function tests, hepatitis serology, liver CT scan
Obstructive jaundice	Yellowish discolouration of the skin and sclerae, dark urine, pale stools, pruritus, abdominal pain	History of cholestasis, physical examination	Abdominal ultrasound, CT or MRI of the abdomen, magnetic resonance cholangiopancreatography (MRCP)