Prepared by 32-Ahmed Samir

36-Ahmed Khattab 49-Ahmed Abdel-Wane

60-Ahmed Shahen66-Ahmed Atwa

Cholestasis

Extrahepatic (obstructive)

Intrahepatic (hepatocellular)

Extrahepatic (obstructive)

Lumen

Wall

Outside

Intrahepatic (hepatocellular)

hereditary

acquired

Causes :-lumen ....

Wall ….

A) Hereditary Dublin –Johnson syndrome Rotor’s syndrome Progressive familial intrahepatic

cholestasis syndromes

Autosomal recessive reduced ability to transport organic anions ….. liver biopsy dark pigment prognosis excellent

same as Dubin-Johnson syndrome except

*it’s autosomal dominant *there is no hepatic

pigmentation

heterogeneous group of conditions …. autosomal recessive the only cure Liver transplantation

B) Acquired Acute hepatitis Liver cirrhosis Drugs

-unconjugated hyperbilirubinemia-conjugated hyperbilirubinemia

Benign recurrent intrahepatic cholestasis

.Dark Urine

Pale Stool

Other symptoms

Pruritis

Yellowed Skin

Clinical Manifes-tations

Nausea vomiting Fever Pain in the abdomen Loss of appetite Fatigue Confusion Headache