Jaundice

Yellowing of the skin and the whites of the eyes, caused by an accumulation of bilirubin in the blood. Jaundice is the chief sign of many disorders of the liver and biliary system. Many babies develop jaundice soon after birth (see jaundice, neonatal). Bilirubin is formed from haemoglobin when old red cells are broken down, mainly by the spleen. It is absorbed by the liver, where it is made soluble in water and excreted in bile. There are 3 main types of jaundice: haemolytic, hepatocellular, and obstructive. In haemolytic jaundice, too much bilirubin is produced for the liver to process. This is caused by excessive haemolysis of red cells, which can have many causes (see anaemia, haemolytic). In hepatocellular jaundice, bilirubin accumulates because its transfer from liver cells into the bile is prevented, usually due to acute hepatitis (see hepatitis, acute) or liver failure. In obstructive jaundice, also known as cholestatic jaundice, bile cannot leave the liver because of bile duct obstruction. Obstructive jaundice can also occur if the bile ducts are not present (as in biliary atresia) or if they have been destroyed by disease. Cholestasis then occurs and bilirubin is forced back into the blood. For all types of jaundice, treatment is for the underlying cause.