Jaundice - Differential Diagnosis Algorithm

Pre-Hepatic - Unconjugated Hyperbilirubinemia

Increased Production

 • Hemolysis

 • Ineffective Erythropoiesis

 • Hematoma

Decreased Hepatic Uptake

 • Sepsis

 • Drugs (e.g. Rifampin)

Decreased Conjugation

 • Gilbert's Syndrome

 • Crigler-Najjar Syndromes (l and II)

Hepatic - Conjugated Hyperbilirubinemia

 • Hepatocellular

 • Cholestatic

 • Dubin Johnson

Post-Hepatic - Usually has Duct Dilatation on Ultrasound

Biliary Duct Compression

 • Malignancy

 • Metastases

 • Pancreatitis

Intraductal Obstruction

 • Gallstones

 • Biliary Stricture

 • Cholangiocarcinoma

 • Primary Sclerosing Cholangitis



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