Jaundice is a topic covered in the 5-Minute Emergency Consult.

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Yellow pigmentation of tissues and body fluids due to hyperbilirubinemia, usually present at levels of >2.5 mg/dL


  • Unconjugated (indirect) hyperbilirubinemia: Unconjugated bilirubin is the direct breakdown product of heme, is water insoluble, and is measured as indirect bilirubin:
    • Hemolytic:
      • Excessive production of unconjugated bilirubin
    • Hepatic:
      • Decreased hepatobiliary excretion of bilirubin by:
        • Defective uptake (drugs, Crigler–Najjar syndrome)
        • Defective conjugation (Gilbert syndrome drugs)
        • Defective excretion of bilirubin by the liver cell (drugs, Dubin–Johnson syndrome)
  • Conjugated (direct) hyperbilirubinemia:
    • Conjugated bilirubin is water soluble and measured as direct bilirubin.
    • In conjugated hyperbilirubinemia, bilirubin is returned to the bloodstream after conjugation in the liver instead of draining into the bile ducts.
    • Hepatocellular dysfunction:
      • Hepatitis
      • Cirrhosis
      • Tumor invasion
      • Toxic injury
    • Intrahepatic (nonobstructive) cholestasis
    • Extrahepatic (obstructive) cholestasis

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