Haemolytic jaundice
In haemolytic (prehepatic) jaundice, more bilirubin is produced than the liver can metabolize, e.g. in severe haemolysis
(breakdown of red cells). The excess bilirubin which builds up in the plasma is mostly of the unconjugated type and is therefore not found in the urine.
Hepatocellular jaundice
In hepatocellular (hepatic) jaundice, there is a build up of bilirubin in the plasma because it is not transported, conjugated, or excreted by the liver cells because they are damaged, e.g. in viral hepatitis. The excess bilirubin is usually of both the unconjugated and conjugated types with bilirubin being found in the urine.
Obstructive jaundice
In obstructive (post-hepatic) jaundice, bilirubin builds up in the plasma because its flow is obstructed in the small bile
channels or in the main bile duct. This can be caused by gallstones or a tumour obstructing or closing the biliary tract. The
excess bilirubin is mostly of the conjugated type and is therefore found in the urine. The term cholestasis is used to describe a failure of bile flow.
See also
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