Presentation on the

topic Jaundice.
 Causes of jaundice

Jaundice may be associated with the following

states:
• violation of the exchange of bilirubin on one or
several stages of metabolism;
• its increased formation in the cells of the RES;
• insufficient excretion of it into bile;
• violation of the outflow of the formed bile
 Types of jaundice

• According to the mechanisms acquired

violation metabolism of bilirubin is released:
• suprahepatic (prehepatic),
• hepatocellular
• (parenchymal) and mechanical (subhepatic,
obstructive) jaundice.
 Hemolytic
jaundice (suprahepatic)
This jaundice is caused by high blood levels of
unconjugated bilirubin.
• • Usually this type of jaundice occurs with overproduction of indirect
bilirubin as a result increased breakdown (hemolysis) of erythrocytes
due to the low resistance of erythrocytes (primary hemolytic
jaundice or with their hemolysis:
• • due to ineffective erythropoiesis (with megaloblastosis |);
• • for large hemorrhages, in the area of ​extensive infarction
• lungs;
• • for malaria;
• • under the influence of hemolytic poisons (secondary hemolytic
• jaundice).
• • Allocate immune hemolytic anemia,
 hemolytic jaundice
*In hemolytic jaundice, there is no cutaneous itching
*The spleen is enlarged (associated with recovery functional activity of
the spleen as organ of extramedullary hematopoiesis, when the bone
marrow is unable to cope with increased and long-term need the body
in the formation of blood cells);
*anemia develops,
*feces are very intensely colored (pleochromia) "due to the formation
of a large the amount of bilirubin And its release in intestines with the
subsequent transition to erasers * ample.
* there is a large amount in the urine urobilin, but there is no direct
bilirubin,which is due to its strong connection with blood albumin
 Hepatocellular jaundice

This type of jaundice,conditioned by defeat

hepatocytes and characterized by raising blood
content both indirect and, direct bilirubin, decrease
Discharge urobiline in urine and stercobilin with
feces.
 Obstructive jaundice(subhepatic)
due to high blood levels conjugated bilirubin due to its
regurgitation into the blood.
• The main causes of regurgitation are violation of the flow of
bile into the duodenal intestine, which is observed when:
• blockage or compression of the hepatic or biliary
duct stones or swelling, including swelling or
tumor metastases at the gate of the liver;
• compression of the mouth of the bile duct by a tumor of the
head pancreas;
• sclerotic changes in the bile ducts with sclerosing
cholangitis.
 Obstructive jaundice
Coloring of the skin when obstructive jaundice is most pronounced;
with prolonged jaundice, the skin acquires dark shade.
• intense itching of the skin;
• when viewed, it shows combs.,
• direct bilirubin is found in urine (in contrast to hemolytic jaundice),
but not detect urobilin (in contrast to parenchymal jaundice);
*urine with obstructive jaundice, very dark
colors, used to describe it the specific term is "beer-colored urine".
• From all other types of jaundice, mechanical
jaundice is distinguished by the acholic character of fecal masses
whose color is milk.
• When examining feces,lack of stercobilin in it.
 Itching.
May be one of the earliest manifestations of diseases liver.
Sometimes he holds extremely stubbornly, throughout many months
and even years old. Itching worse nights. It leads to combing. Itching
most often combined with jaundice. Itchy skin associated with
accumulation in the blood of the big the amount of bile acids and
their annoying action on skin endings.