Jaundice (icterus)

21 October 2017

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Jaundice (jaundice) occurs when the bile pigment bilirubin in the blood increases. Due to the increased Konzentratioin of the yellow dye in the tissue take skin and mucous membranes to a yellowish color. What is there to be observed especially in newborn babies.

If discolored in newborns in the first days after the skin tone to yellowish-brown, this is generally not unusual: About 60 percent of all newborns are affected by jaundice. After a week, the baby's skin will usually return to a pink color.

In adults, jaundice may indicate various diseases, especially of the liver and bile.

Jaundice (icterus) is a yellowing of the skin and mucous membranes, caused by an increased concentration of bile pigment bilirubin in the tissue.

Of the pathological causes of jaundice in adults mostly harmless yellowing the skin in infants. These Neonatal jaundice is technical terminology also neonatal jaundice

The jaundice (jaundice) has its roots in high bilirubin in the blood and hence is evidence of a disturbed bilirubin metabolism. Bilirubin is a degradation product of hemoglobin hemoglobin. In various diseases of the liver, biliary tract and blood is too much of it before the blood. It then deposited in the tissues and leads to a visible yellow Skin, mucous membrane and sclera of the eye (sclera).

From a total bilirubin concentration above two milligrams per deciliter (mg / dl) blood jaundice becomes apparent as yellowing of the eyes.

since the liver plays a central function in the bilirubin metabolism, physicians share the causes of jaundice in accordance with their location in relation to the liver (Greek .: Hepar) a:

From a prehepatic jaundice speaking doctors, if the jaundice Causes before liver lie. When prehepatic jaundice come as causes especially blood diseases in which an excessive number of red blood cells (RBCs) fall apart (so-called. Hemolysis). The result is increased bilirubin, the breakdown product of red blood pigment hemoglobin. Even with complications for blood transfusions a praehepatic jaundice may occur. The prehepatic jaundice is also non-hepatic jaundice named because the causes of the pathological process is not in the liver, but in the blood are.

When hepatic jaundice is the cause for jaundice in the liver. a liver inflammation (hepatitis) More specifically, in this form of the reason for the jaundice. Liver inflammation may include viruses (e.g., hepatitis B), by drugs and alcohol abuse are caused (through to liver cirrhosis). A congenital metabolic disorder that can lead to jaundice, is the so-called familial hyperbilirubinemia.

The posthepatic jaundice has its causes in a disorder that occurs after the blood has left the liver. Various diseases or surgery can have a biliary stasis (so-called. Cholestasis) cause and thereby cause jaundice.

are in the posthepatic jaundice moved biliary tract or disturbances in bile flow the most common causes. The liver produces bile and releases it via the bile ducts in the gallbladder and ultimately into the intestine from. There, the bile is involved in digestion. Bile contains bile pigment bilirubin. If the bile ducts closed, accumulates bile (Cholestasis), and bilirubin as well as other components of bile pass over into the blood. are other names for the posthepatic jaundice obstructive or obstructive.

As part of a jaundice leads to a yellowing of the eyes. © Vincent Zuber / CMSP / OKAPIA © Okapia

As part of a jaundice leads to a yellowing of the eyes. © Vincent Zuber / CMSP / OKAPIA

Gallstones can - as well as tumors (e.g., gallbladder cancer, liver cancer, pancreatic cancer) or adhesive bonds by inflammation or operations - the close bile ducts. Since then turn cholestasis (biliary obstruction) occurs, these diseases also are eligible for jaundice causes.

As part of a jaundice may - depending on the cause - in addition to the typical yellowing come to various other symptoms, such as:

As there are numerous reasons for jaundice (jaundice), it is important for the right cause to search. First, a help detailed conversation (Anamnesis) the doctor, the cause narrow a little. He asks, for example:

Followed by a thorough physical examination, so the doctor can narrow down the possible causes of jaundice on. He scans among others, the liver and the gallbladder under the right ribs carefully. 

Further information about the possible cause of jaundice is a blood test, in which mainly the values ​​of bilirubin, of hemoglobin (Red blood dye) red blood cells (Erythrocytes), and certain bile and liver function tests (e.g., gamma-GT, alkaline phosphatase, GOT, GPT) and inflammation values ​​are of particular interest. Also in Urine and faeces bilirubin can be detected under certain circumstances, which is why urine and stool tests complete the laboratory tests for jaundice.

Facts about elevated liver values

The term "liver function tests" summarizes the concentration of certain enzymes together in the blood.

Another useful feature is an ultrasound of the upper abdomen. The physician liver, gallbladder and bile ducts can examine changes and the possible causes of jaundice. Further investigations are required depending on the findings. This includes:

For example, if a sealed by a gallstone bile duct is the cause of the jaundice, the doctor removes the stone. Then the bile can flow again and the yellowing of the skin also disappears. Bilirubin levels normalize again. In this case, the doctor will treat the jaundice using an endoscopy or surgery. 

If alcohol, drugs or other toxins are responsible for jaundice, it is essential to eliminate these harmful substances and to discuss how to proceed with the attending physician. A hepatitis must also be effectively treated (e.g., the hepatitis B virus with inflammatory drugs). As a consequence, the bilirubin levels in the blood decreases, and the skin and mucous membranes return to their normal color.


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