Cholestasis

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In medicine, cholestasis is a condition where bile cannot flow from the liver to the duodenum. Bile formation is a secretory function of the liver. It begins in bile canaliculi that form between two adjacent surfaces of liver cells (hepatocytes) similar to the terminal branches of a tree. The canalculi join each other to form larger and larger structures, sometimes referred to as Canals of Hering, which themselves join to form small bile ductules that have an epithelial surface. The ductules join to form bile ducts that eventually form either the right main hepatic duct that drains the right lobe of the liver and the left main hepatic duct draining the left lobe of the liver. The two ducts join to form the common hepatic duct, which in turn joins the cystic duct from the gall bladder, to give the common bile duct. This duct then enters the duodenum at the ampulla of Vater. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system such as can occur from a gallstone or malignancy and metabolic types of cholestasis which are disturbances in bile formation that can occur because of genetic defects or acquired as a side effect of many medications.

Contents 1 Etiology 2 Symptoms 3 See also 4 External links

[edit] Etiology

• gallstones
• abdominal mass (e.g. cancer)
• primary sclerosing cholangitis, secondary to inflammatory bowel disease
• Primary biliary cirrhosis, secondary to autoimmune disorders
• congenital anomalies of the bilary tract
• biliary trauma
• some drugs, (e.g. Flucloxacillin and Erythromycin)
• in children, biliary atresia and other pediatric liver diseases
• Pregnancy, referred to as Intrahepatic Cholestasis of Pregnancy, or Obstetric Cholestasis

[edit] Symptoms

• Pale stools,
• dark urine,
• itchiness (pruritus) and
• jaundice.

Bile is secreted by the liver to aid in the digestion of fats. Drugs such as gold salts,nitrofurantoin, anabolic steroids, chlorpromazine, prochlorperazine, sulindac, cimetidine, erythromycin, can cause cholestasis and may result in damage to the liver.

[edit] See also

• Jaundice
• Liver function tests
• Lipoprotein-X - an abnormal low density lipoprotein found in cholestasis
• Intrahepatic Cholestasis of Pregnancy

[edit] External links

• Drug-induced cholestasis - medlineplus.org
• Cholestasis - emedicine.com
• Liver Families = pediatric liver support group
• Itchy Moms - information about Obstetric Cholestasis / Cholestasis of Pregnancy
• OC Support website - OC Support website: information about Obstetric Cholestasis, research, support, shared experiences, discussion forum.