Ikterichnost (Jaundice)

Description:

Jaundice (Latin icterus) — the icteric coloring of skin and visible mucous membranes caused by the increased content in blood and fabrics of bilirubin.

Jaundice (true) — the symptom complex which is characterized by icteric coloring of skin and mucous membranes, caused by accumulation in fabrics and blood of bilirubin.

Ikterichnosti's (Jaundice) symptoms:

Jaundice — the symptom complex representing coloring in yellow skin color, scleras, mucous membranes. Intensity of coloring can be absolutely different — from pale yellow color to saffron-yellow-orange. Moderately expressed jaundice without discoloration of urine is characteristic of not conjugated hyperbilirubinemia (at hemolysis or Gilbert's syndrome). More expressed jaundice or jaundice with discoloration of urine testifies to gepatobiliarny pathology. Urine with jaundices gains dark color owing to a hyperbilirubinemia from patients. Sometimes change of coloring of urine precedes developing of jaundice. All other clinical displays of jaundice depend on the reasons which caused its development. In certain cases discoloration of skin and scleras is the only complaint of the patient (for example at Gilbert's syndrome), and in other cases jaundice is only one of many clinical displays of a disease. Therefore it is necessary to establish the jaundice reason. It is necessary to distinguish true jaundice from a hyper carotenemia at the patients using a large number of carrots. At emergence of jaundice it is necessary to think first of all of existence at the patient of gepatobiliarny pathology which results from a cholestasia or hepatocellular dysfunction. The cholestasia can be inside - and extrahepatic. Hemolysis, Gilbert's syndrome, virus, toxic damages of a liver, liver pathology at general diseases — the intra hepatic reasons of a cholestasia. Stones in a gall bladder — the extrahepatic reasons of a cholestasia. Some clinical manifestations accompanying jaundice (in more detail the clinical symptomatology is considered in the sections devoted to various diseases):

    * At a cholestasia jaundice is found, there is an urine of dark color, there is a generalized skin itch.
    * At a chronic cholestasia bleedings (because of vitamin K absorption disturbance) or ostealgias are possible (osteoporosis because of the broken absorption of vitamin D and calcium).
    * A fever, hepatic gripes or pain in a patognomonichna pancreas for an ekstrapechenochny cholestasia.
    * Xanthomas (hypodermic deposits of cholesterol) and a ksantelazma (the small formations of pale yellow color in an upper eyelid caused by adjournment of lipids in them) can be found in patients with a cholestasia.
    * Symptoms of chronic damage of a liver (vascular asterisks, a splenomegaly, ascites) testify to an intra hepatic cholestasia.
    * Symptoms of portal hypertensia or portosistemny encephalopathy of a patognomonichna for chronic damage of a liver.
    * At patients with a hepatomegalia or ascites swelling of cervical veins testifies to heart failure or chronic cardial compression.
    * At metastasises in a liver the patient with jaundice can have a cachexia.
    * The progressing strengthening of anorexia and fervescence is characteristic of alcoholic damage of a liver, chronic hepatitis and malignant new growths.
    * The nausea and vomiting preceding development of jaundice indicate an acute hepatitis or obstruction of the general bilious channel by a stone.
    * Clinical manifestations of the hereditary syndromes which are followed by emergence of jaundice.

Ikterichnosti's (Jaundice) reasons:

True jaundice can develop as a result of three main reasons:

  1. excessive destruction of erythrocytes and the increased production of bilirubin — hemolitic or suprahepatic jaundice;
  2. catching disturbances by cells of a liver of bilirubin and its linkng with glucuronic acid — parenchymatous or pechyonochnokletochny jaundice;
  3. existence of an obstacle to release of bilirubin with bile in intestines and the return absorption of the connected bilirubin in blood — mechanical or subhepatic jaundice.

Jaundice false (a pseudoicterus, carotene jaundice) — icteric coloring of skin (but not mucous membranes!) owing to accumulation of karotin in it at long and plentiful consumption of carrots, beet, oranges, pumpkins, and also arising at intake of quinacrine, picric acid and some other drugs.

Ikterichnosti's (Jaundice) treatment:

The patient with jaundice needs to be hospitalized as soon as possible for the purpose of specification of the diagnosis and performing rational treatment. Very important and quite often paramount value has treatment of a basic disease, including an operative measure (for example, at obturatsionny jaundices).