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Obstructive Jaundice Versus Cholestatic Liver Disease

Perbedaan antara Ikterik Obstruktif dengan Penyakit Hati Kolestatik

Feature Suggests Obstructive Jaundice Suggests Parenchymal Liver Disease
History Abdominal pain Anorexia, malaise, myalgias, suggestive of a viral prodrome
Fever, rigors Known infectious exposure
Previous biliary surgery Receipt of blood products, use of intravenous drugs
Older age Exposure to a known hepatotoxin
Acholic stools Family history of jaundice
Physical examination High fever Ascites
Abdominal tenderness Other stigmata of liver disease (e.g., prominent abdominal veins, gynecomastia, spider angiomas, asterixis, encephalopathy, Kayser-Fleischer rings)
Palpable abdominal mass
Abdominal scar
Laboratory studies Predominant elevation of serum bilirubin and alkaline phosphatase Predominant elevation of serum aminotransferases
Prothrombin time that is normal or normalizes with vitamin K administration Prolonged prothrombin time that does not correct with vitamin K administration
Elevated serum amylase Blood tests indicative of specific liver disease

Cecil Medicine 23rd Edition (Saunders) 2008

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