45
H Tiêu hóa
Map 3.6 Vàng da
Investigations
You must determine underlying cause.
Use these tests to determine the type of jaundice:
•
Appearance of urine and stool.
•
LFTs.
•
Bilirubin levels.
•
Alkaline phosphatase levels.
The different blood results for different types of jaundice:
Posthepatic
jaundice
↑
↑
↑
↑
↑
↑
↑
Pale
Dark
Pale
Dark
Investigations
Prehepatic
jaundice
Intrahepatic
jaundice
Appearance of
urine
Normal
Normal
Normal
Normal
Normal or ↑
Normal or ↑
Normal
Appearance of
stool
Conjugated
bilirubin
Unconjugated
bilirubin
Total bilirubin
Alkaline
phosphatase
What is jaundice?
Jaundice, also known as icterus,
is the yellow discolouration of
mucous membranes, sclera and skin.
This happens due to the accumulation
of bilirubin. Jaundice may be seen at a
bilirubin concentration >2.5–3.0 mg/dL
(42.8–51.3 mmol/L).
Causes
The causes of jaundice
may be split into 3 categories
(see Table below):
1 Prehepatic jaundice.
2 Intrahepatic jaundice.
3 Posthepatic jaundice.
Treatment
Treat the underlying cause.
Complications
•
Liver failure.
•
Renal failure.
•
Sepsis.
•
Pancreatitis.
•
Biliary cirrhosis
•
Cholangitis
•
Kernicterus (a serious
complication of
jaundice in neonates).
Nguyên nhân c a t ng lo i vàng da
Vàng da trư c gan
Vàng da t i gan
Vàng da sau gan
H i ch ng Crigler–Najjar
H i ch ng Gilbert
Tán huy t, e.g. thalassaemia,
thi u máu h ng c u hình li m
Do thu c, e.g. rifampicin
S t rét
H i ch ng tan huy t tăng ure máu
B nh gan do rư u
Ung thư t y
Xơ gan
Xơ gan m t nguyên phát
B nh do Leptospira
Vàng da sinh lý sơ sinh
\S i ng m t ch
B nh sán máng
Teo đư ng m t
Ung thư bi u mô đư ng m t
H i ch ng Mirizzi
Viêm gan do virus, do rư u
MAP 3.6 Vàng da
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