Hemolytic jaundice

Hepatocellular jaundice

Intrahepatic cholestatic jaundice

Extrahepatic cholestatic jaundice

Symptoms

May be asymptomatic or with back ache, joint pain.

Nausea, vomiting, fever, anorexia

Deep jaundice, dark-colored urine, clay-colored stools, pruritus

Deep jaundice, dark-colored urine, clay-colored stools, pruritus, cholangitis, biliary colic

Physical Findings

Splenomegaly

Tender hepatomegaly, ± splenomegaly

Tender hepatomegaly

Hepatomegaly, palpable gallbladder

Total Bilirubin

< 6 mg/dL

Variable

Variable, may be

> 30 mg/dL

< 30 mg/dL

Direct Bilirubin

< 20%

> 50%

> 50%

> 50%

ALT

Normal

> 5x normal

2-5x normal

< 2-3x normal; if with cholangitis > 3-5x normal

AST

Normal

< 2-3x normal

< 3-5x normal

> 3-5x normal

PT (corrects with vitamin K)

Normal

Prolonged (no)

Prolonged (variable)

Prolonged (yes)

Biliary dilatation on U/S?

No

No

No

Yes

ERCP

Not necessary

Not necessary

Usually not necessary

Usually necessary