KOLESTASIS PDF

Diagnosis Your doctor will ask questions about your medical history. Blood tests may be ordered to test for liver enzymes that indicate cholestasis. If test results are abnormal, your doctor may order imaging tests like ultrasound or MRI. Your doctor may also perform a liver biopsy. Treatment The first step to treating cholestasis is to treat the underlying cause. If an obstruction like gallstones or a tumor is causing the backup of bile, your doctor may recommend surgery.

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Mechanism[ edit ] Bile is secreted by the liver to aid in the digestion of fats. Bile formation begins in bile canaliculi that form between two adjacent surfaces of liver cells hepatocytes similar to the terminal branches of a tree.

The canaliculi join each other to form larger and larger structures, sometimes referred to as the 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, or 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. In cholestasis, bile accumulates in the hepatic parenchyma. With a few exceptions, the optimal test for cholestasis would be elevations of serum bile acid levels. However, this is not normally available in most clinical settings. Normally GGT and ALP are anchored to membranes of hepatocytes and are released in small amounts in hepatocellular damage.

In cholestasis, synthesis of these enzymes is induced and they are made soluble. GGT is elevated because it leaks out from the bile duct cells due to pressure from inside bile ducts.

Histopathology[ edit ] Under a microscope , the individual hepatocytes will have a brownish-green stippled appearance within the cytoplasm , representing bile that cannot get out of the cell. Canalicular bile plugs between individual hepatocytes or within bile ducts may also be seen, representing bile that has been excreted from the hepatocytes but cannot go any further due to the obstruction.

When these plugs occur within the bile duct, sufficient pressure caused by bile accumulation can cause them to rupture, spilling bile into the surrounding tissue , causing hepatic necrosis. These areas are known as bile lakes, and are typically seen only with extra-hepatic obstruction. Pruritis in cholestatic jaundice is treated by antihistamines, ursodeoxycholic acid, and phenobarbital. Nalfurafine hydrochloride can also treat pruritus caused by chronic liver disease and was recently approved in Japan for this purpose.

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contoh lapkas Kolestasis pada anak

Namun, kasus kolestasis cukup banyak ditemui di Indonesia. Anda bisa mengenali berbagai gejala empedu bermasalah yang satu ini, seperti penyakit kuning pada kulit dan mata atau gatal pada beberapa bagian tubuh anda. Hal ini akan membuat empedu menumpuk di beberapa bagian pada tubuh. Cairan empedu yang menumpuk ini akan membuat kulit dan mata anda menjadi kuning. Hal ini juga bisa membuat tubuh anda gatal tepat pada bagian yang mengalami penumpukan cairan empedu. Apa yang bisa membuat saluran empedu tersumbat dan mengakibatkan terjadinya penyakit kolestasis?

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Kolestasis

Mechanism[ edit ] Bile is secreted by the liver to aid in the digestion of fats. Bile formation begins in bile canaliculi that form between two adjacent surfaces of liver cells hepatocytes similar to the terminal branches of a tree. The canaliculi join each other to form larger and larger structures, sometimes referred to as the 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, or 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. In cholestasis, bile accumulates in the hepatic parenchyma.

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