Page 179 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

A. Types of Jaundice
Hemolysis etc. Jaundice:
Blood
Hemoglobin etc. Bilirubin Production Pre-
hepatic
· Specific syndromes Uptake
(Gilbert, Crigler-Najjar,
Dubin-Johnson, Rotor) Conjugation Conjugated
· Acute and chronic bilirubin
liver damage (Icterus), Cholestasis
· Drug side effects Secretion Intrahepatic
· Estrogens, cystic Outflow
fibrosis, etc. = Cholestasis
Jaundice
Liver

Post-
Gall stones, tumors, etc. Extrahepatic hepatic
outflow
B. Mechanisms and Consequences of Cholestasis Plate 6.18
Blood Bile salts, Liver cell
bilirubin,
cholesterol Mitochondria
Enzymes, Carrier insertion
copper, on wrong side
endorphins
ATP ATP synthesis
impaired
Fluidity of
cell membrane Drugs
Retention of
bile components
Cholestasis
Deformation of
Bile salts increase brush border
permeability of
tight junctions
Dilation Bile salt
deficiency
in intestine

Bilirubin Icterus
Endorphins (?)
Bile salts (?) Pruritus Cholangitis
Cholesterol Cholesterol Fat stools,
(hepatic breakdown , deposition vitamin A, E and
enteral synthesis ) K deficiency
169

Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
All rights reserved. Usage subject to terms and conditions of license.