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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