- Definition: Cholestasis is defined as stasis in any region from the release of bile to the intracanalicular distance by the hepatocytes until it empties into the duodenum.
• In cholestasis, first of all, the direct bilirubin fraction increases.
- Classification: Cholestasis is divided into two groups depending on whether the pathology is in the hepatic or extrahepatic bile ducts. USG can help in its differentiation.
intrahepatic; It can be seen in viral hepatitis, alcoholic hepatitis, drugs, primary biliary cholangitis, primary sclerosing cholangitis, infiltrative diseases (tuberculosis, amyloidosis, lymphoma, sarcoidosis), congestive hepatopathy, ischemic hepatitis, pregnancy, total parenteral nutrition, paraneoplastic syndromes.
• Extrahepatic; choledocholithiasis ( most common), postoperative biliary strictures, primary sclerosing cholangitis, chronic pancreatitis, Mirizzi syndrome, parasites (Ascaris, Fasciola) or tumors (gallbladder, biliary tract, ampulla, pancreatic tumors or metastasis).
- Clinical and laboratory: Itching and jaundice are typical clinically in diseases with cholestasis.
• If there is severe biliary obstruction, stool discoloration (acholic stool)
visible. Urobilinogen is lost in the urine.
• Prolonged cholestasis may lead to malabsorption findings with malabsorption in fat and ADEK vitamins.
• Again, secondary biliary cirrhosis may develop due to prolonged jaundice, degeneration and fibrosis in the liver due to the toxic effect of bile on the liver.
- Treatment: In cases where cholestasis is extrahepatic, biliary drainage should be provided as soon as possible by endoscopic, percutaneous or surgical methods.
• Conditions leading to intrahepatic cholestasis are treated according to the underlying cause, and supportive treatment is given if necessary.
• Ursodeoxycholic acid may help to improve the clinic in some cholestatic diseases by removing toxic bile acids.
• In cholestasis, first of all, the direct bilirubin fraction increases.
- Classification: Cholestasis is divided into two groups depending on whether the pathology is in the hepatic or extrahepatic bile ducts. USG can help in its differentiation.
intrahepatic; It can be seen in viral hepatitis, alcoholic hepatitis, drugs, primary biliary cholangitis, primary sclerosing cholangitis, infiltrative diseases (tuberculosis, amyloidosis, lymphoma, sarcoidosis), congestive hepatopathy, ischemic hepatitis, pregnancy, total parenteral nutrition, paraneoplastic syndromes.
• Extrahepatic; choledocholithiasis ( most common), postoperative biliary strictures, primary sclerosing cholangitis, chronic pancreatitis, Mirizzi syndrome, parasites (Ascaris, Fasciola) or tumors (gallbladder, biliary tract, ampulla, pancreatic tumors or metastasis).
- Clinical and laboratory: Itching and jaundice are typical clinically in diseases with cholestasis.
• If there is severe biliary obstruction, stool discoloration (acholic stool)
visible. Urobilinogen is lost in the urine.
• Prolonged cholestasis may lead to malabsorption findings with malabsorption in fat and ADEK vitamins.
• Again, secondary biliary cirrhosis may develop due to prolonged jaundice, degeneration and fibrosis in the liver due to the toxic effect of bile on the liver.
- Treatment: In cases where cholestasis is extrahepatic, biliary drainage should be provided as soon as possible by endoscopic, percutaneous or surgical methods.
• Conditions leading to intrahepatic cholestasis are treated according to the underlying cause, and supportive treatment is given if necessary.
• Ursodeoxycholic acid may help to improve the clinic in some cholestatic diseases by removing toxic bile acids.