Cholestasis An alternative or concomitant response to injury caused by extrahepatic or intrahepatic obstruction to bile flow Accumulation in serum of substances normally excreted in bile such as direc-reacting bilirubin choesterol bile acid trace elements occurs
Cholestasis ◼ An alternative or concomitant response to injury caused by extrahepatic or intrahepatic obstruction to bile flow. ◼ Accumulation in serum of substances normally excreted in bile such as ◼ direc-reacting bilirubin ◼ choesterol ◼ bile acid ◼ trace elements occurs
Neonatal cholestasis a Neonatal cholestasis is defined a prolonged elevation of serum levels of conjugated bilirubin beyond the first 14 days of life Jaundice that appears after 2 wk of age progress after this time, or does not resolve at this time should be evaluated and a direct bilirubin level determined
Neonatal cholestasis ◼ Neonatal cholestasis is defined a sprolonged elevation of serum levels of conjugated bilirubin beyond the first 14 days of life. ◼ Jaundice that appears after 2 wk of age, progress after this time, or does not resolve at this time should be evaluated and a direct bilirubin level determined
Neonatal cholestasis May be due to infectious genetic metabolic, or undefined abnormalities mechanical obstuction of bile flow functional impairment of hepatic excretory function and bile secretion May be divided into extrahepatic and intrahepatic disease
Neonatal cholestasis ◼ May be due to infectious, genetic, metabolic, or undefined abnormalities ◼ mechanical obstuction of bile flow ◼ functional impairment of hepatic excretory function and bile secretion. ◼ May be divided into extrahepatic and intrahepatic disease
Neonatal cholestasis Neonatal cholestasis Intrahepatic disease Extrahepatic disease(bile duct injury or Hepatocyte injury Bile duct injury obstruction) Metabolic Viral Idiopathic Intrahepatic Extrahepatic disease neonatal disease bile duct biliary hepatitis hypoplasia atresia or paucity
Neonatal cholestasis Neonatal cholestasis Intrahepatic disease Extrahepatic disease (bile duct injury or obstruction) Extrahepatic biliary atresia Hepatocyte injury Bile duct injury Intrahepatic bile duct hypoplasia or paucity Metabolic disease Viral disease Idiophathic neonatal hepatitis
Extrahepatic disorders Biliary atresia sclerosing cholangitis Bile duct stenosis Choledochal cyst Choledochal-pancreaticoductal junction Anomaly Spontaneous perforation of the bile duct Mass(neoplasia, stone) Bile/mucous plug
Extrahepatic disorders ◼ Biliary atresia ◼ sclerosing cholangitis ◼ Bile duct stenosis ◼ Choledochal cyst ◼ Choledochal-pancreaticoductal junction Anomaly ◼ Spontaneous perforation of the bile duct ◼ Mass (neoplasia, stone) ◼ Bile/mucous plug