Cholestasis
| Classification according to ICD-10 | |
|---|---|
| K71 | Toxic liver disease |
| K71.0 | Toxic liver disease with cholestasis |
| K80 | Cholelithiasis |
| K80.3 | Bile duct stone with cholangitis |
| K80.4 | Bile duct stone with cholecystitis |
| K80.5 | Bile duct stone without cholangitis or cholecystitis |
| ICD-10 online (WHO version 2019) | |
Cholestasis ( bile congestion, composed of bile ( gr. Χολή cholé ) and congestion (gr. Στάσις stase )) describes the backlog of bilirubin , bile acids and other bile components due to reduced or absent flow of bile into the intestine .
to form
Extrahepatic
In most cases of extrahepatic cholestasis, there is a mechanical obstruction in the biliary tract due to stones, tumors or scarred indentations.
Intrahepatic
Viral hepatitis, hemangiomas , drugs, pregnancy, or toxins can cause intrahepatic cholestasis.
In the newborn
With very high levels of bilirubin, e.g. B. in the case of blood group intolerance, biliary thrombi can develop with an intrahepatic biliary obstruction with the appearance of obstructive jaundice. The condition is usually reversible, but in rare cases an operative revision may be necessary.
This was formerly known as syndrome of thickened gall , Gallenpfropfsyndrom , Gross-Ladd syndrome or Latin jaundice of the newborn gravis referred.
Symptoms
The main clinical symptom is increasing posthepatic jaundice with varying degrees of severity depending on the extent and severity of the flow obstruction and pale stool . Added to this are fatigue, loss of appetite , itching and nausea . The other symptoms depend on the triggering cause. Acute colic-like pain is an indication of trapped gallstones .
Diagnosis
Sonographically , the intrahepatic bile ducts appear dilated in extrahepatic cholestasis. The intrahepatic bile ducts run parallel to the branches of the portal vein and are not visible sonographically if the findings are normal. However , if the bile backs up in the liver , the bile ducts become visible parallel to the portal veins. This sonographic image in the liver is referred to as the “double-shotgun phenomenon”.
A laboratory diagnosis should be considered under certain circumstances, to confirm the diagnosis. An elevated level of alkaline phosphatase is the most sensitive indicator of cholestasis.
See also
Individual evidence
- ^ FC Sitzmann: Pediatrics. Diagnostics - therapy - prophylaxis. 6th edition, Hippocrates 1988, ISBN 3-7773-0827-7 .
- ↑ D. Reiche et al.: Roche Lexicon Medicine. Verlag Elsevier Health Sciences, 2003, ISBN 3-437-15156-8 , (online)
- ^ H. Jacobi: Icterus gravis in the neonatal period. Therapy and prognosis. In: Medical Clinic. Vol. 64, No. 13, March 1969, pp. 580-583, PMID 5814983 .
