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Journal of the American College of... May 2019Jaundice is the end result of myriad causes, which makes the role of imaging in this setting particularly challenging. In the United States, the most common causes of...
Jaundice is the end result of myriad causes, which makes the role of imaging in this setting particularly challenging. In the United States, the most common causes of all types of jaundice fall into four categories including hepatitis, alcoholic liver disease, blockage of the common bile duct by a gallstone or tumor, and toxic reaction to a drug or medicinal herb. Clinically, differentiating between the various potential etiologies of jaundice requires a detailed history, targeted physical examination, and pertinent laboratory studies, the results of which allow the physician to categorize the type of jaundice into mechanical or nonmechanical causes. Imaging modalities used to evaluate the jaundiced patient (all etiologies) include abdominal ultrasound (US), CT, MR cholangiopancreatography, endoscopic retrograde cholangiopancreatography and endoscopic US. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Topics: Contrast Media; Diagnosis, Differential; Evidence-Based Medicine; Humans; Jaundice; Societies, Medical; United States
PubMed: 31054739
DOI: 10.1016/j.jacr.2019.02.012 -
La Revue Du Praticien May 2011
Topics: Humans; Jaundice
PubMed: 21698908
DOI: No ID Found -
AACN Clinical Issues Nov 1999Bilirubin metabolism is a complex and fascinating example of the body's ability to discard, renew, and recycle vital elements. Jaundice is the warning sign for... (Review)
Review
Bilirubin metabolism is a complex and fascinating example of the body's ability to discard, renew, and recycle vital elements. Jaundice is the warning sign for derangements in this system. As is true of pain, jaundice is a powerful impetus for visiting a healthcare provider. Usually associated with hepatitis by a nonclinician, the origins of jaundice can range from benign to fatally malignant. Patients may have any number of idiopathic or nosocomial conditions that can contribute to an icteric state. This review delineates the steps of bilirubin metabolism, enumerates the sources of bilirubin derangement, and examines elements of patient condition and therapeutics that can contribute to hyperbilirubinemia and jaundice.
Topics: Bilirubin; Diagnosis, Differential; Humans; Jaundice; Nursing Assessment; Physical Examination
PubMed: 10865528
DOI: 10.1097/00044067-199911000-00003 -
The Surgical Clinics of North America Dec 2006Hyperbilirubinemia, or jaundice, is common in the ICU, with incidence up to 40% among critically ill patients. Unfortunately, it is poorly understood in the critically... (Review)
Review
Hyperbilirubinemia, or jaundice, is common in the ICU, with incidence up to 40% among critically ill patients. Unfortunately, it is poorly understood in the critically ill, and too often presents a diagnostic dilemma to the ICU physician. Causes of jaundice in the ICU are multiple; the etiology in any given patient, multifactorial. Acute jaundice can be a harbinger or marker of sepsis, multisystem organ failure (MSOF), or a reflection of transient hypotension (shock liver), right-sided heart failure, the metabolic breakdown of red blood cells, or pharmacologic toxicity. Acute ICU jaundice is best divided into obstructive and nonobstructive. This stratification directs subsequent management and therapeutic decisions.
Topics: Animals; Comorbidity; Humans; Intensive Care Units; Jaundice; Jaundice, Obstructive; Multiple Trauma; Parenteral Nutrition, Total; Prognosis
PubMed: 17116459
DOI: 10.1016/j.suc.2006.09.007 -
Mayo Clinic Proceedings Jul 2022
Topics: Female; Humans; Jaundice; Pain
PubMed: 35787864
DOI: 10.1016/j.mayocp.2022.01.017 -
NeoReviews Nov 2021
Topics: Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Jaundice
PubMed: 34725142
DOI: 10.1542/neo.22-11-e770 -
Indian Journal of Medical Microbiology Jul 2021A 52 year old previously healthy woman from Mumbai presented with fever and jaundice of 10 days duration. At admission, she was jaundiced with tachycardia, tachypnea,...
A 52 year old previously healthy woman from Mumbai presented with fever and jaundice of 10 days duration. At admission, she was jaundiced with tachycardia, tachypnea, hypoxia, hypotension, conjunctival congestion and mild erythematous flush over the skin. She had very high WBC counts and CRP's with direct hyperbilirubinemia and azotemia. Investigations for infectious causes of fever were negative. RT-PCR for SARS-CoV-2 in the nasopharynx was negative. However her SARS-CoV-2 antibodies were reactive. She also had echocardiographic and biochemical evidence of cardiac dysfunction. The diagnosis of Multisystem inflammatory syndrome-Adult (MIS-A) was thus established. She rapidly improved with intravenous immunoglobulin (2 gm/kg) and high dose steroids.
Topics: Azotemia; COVID-19; Echocardiography; Fever; Humans; Hyperbilirubinemia; Immunoglobulins; Jaundice; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Steroids
PubMed: 33617927
DOI: 10.1016/j.ijmmb.2021.02.001 -
Revista de Gastroenterologia de Mexico Nov 2005
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Australian Family Physician Apr 1991Always take a full travel, drug and contact history in any patient presenting with jaundice. All drugs should be suspected as potential hepatotoxins. With hepatitis A...
Always take a full travel, drug and contact history in any patient presenting with jaundice. All drugs should be suspected as potential hepatotoxins. With hepatitis A the presence of IgM antibodies reflects recent infection, and IgG antibody indicates past infection and lifelong immunity. There is no chronic carrier state of hepatitis A and E. All patients with jaundice should be tested for hepatitis B surface antigen (HBsAg). Hepatitis B infection is usually benign and short lived, but it can be fatal if chronic hepatitis develops, which may lead later to cirrhosis and hepatocellular carcinoma. Up to 5 to 10 per cent of patients with hepatitis B will become chronic carriers (especially drug addicts and homosexuals). Such carriers are identified by persistent titres of HBsAg and possibly HBeAg, the latter indicating the presence of the whole virus and active replication and high infectivity. A raised gamma glutamyl transferase accompanied by a raised MCV is a good screening test for alcohol abuse.
Topics: Diagnosis, Differential; Humans; Jaundice
PubMed: 2048997
DOI: No ID Found -
Digestive Diseases (Basel, Switzerland) 1986In jaundiced patients, the most important diagnostic problem is to achieve a correct differentiation between nonobstructive and obstructive causes of jaundice. Several... (Review)
Review
In jaundiced patients, the most important diagnostic problem is to achieve a correct differentiation between nonobstructive and obstructive causes of jaundice. Several new diagnostic tests are available to the clinician. Noninvasive tests include: US, CT and CS, invasive tests are: PTC and ERC. The latter also have therapeutic potentials to be considered. For a proper selection of diagnostic tests in a particular case, clinical evaluation as to the most probable cause of jaundice is mandatory, because the new tests all have their limited field of application. The accuracies of clinical evaluation, noninvasive and invasive tests are therefore reviewed and a flow chart for the differential diagnosis in jaundice is suggested. The clinical evaluation, which may be assisted by a diagnostic chart presented, should sort out patients with probable obstructive or nonobstructive jaundice in whom direct cholangiography or liver biopsy, respectively, is the most appropriate diagnostic test. In the remaining group of patients with clinically doubtful causes of jaundice, or if liver metastases are the most likely diagnosis, US seems to be the test best suited for further differentiation before direct cholangiography or liver biopsy are used as confirmatory tests.
Topics: Cholangiography; Cholestasis; Endoscopy; Humans; Jaundice; Ultrasonography
PubMed: 3555894
DOI: 10.1159/000171152