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Cholestasis: classification
Last reviewed: 23.04.2024
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[Extrahepatic cholestasis
It develops with mechanical obstruction of the bile ducts, usually outside the liver; at the same time, obstruction in the cholangiocarcinoma of the liver gates that germinate the main intrahepatic ducts can also be attributed to this group. The most common cause of extrahepatic cholestasis is the stone of the common bile duct; Other causes include pancreatic cancer and fatal nipple, benign duct strictures and cholangiocarcinoma. These diseases often cause acute cholestasis.
Intrahepatic cholestasis
It develops in the absence of obstruction of the main bile ducts (according to cholangiography). The causes of cholestasis are drugs, cholestatic hepatitis, hormones, primary biliary cirrhosis, sepsis. Primary sclerosing cholangitis can be accompanied by the development of both extra- and intrahepatic cholestasis, depending on the localization of the lesion and the presence of strictures of the common bile duct. Rare reasons for cholestasis are Byler's disease, benign recurrent cholestasis, lymphogranulomatosis (Hodgkin's disease) and amyloidosis. Intrahepatic cholestasis can be acute (for example, under the influence of drugs) or chronic (for example, with primary biliary cirrhosis, primary sclerosing cholangitis).
Distinguish the types of cholestasis by clinical symptoms and biochemical indicators is not always possible. It is extremely important to distinguish between extra- and intrahepatic cholestasis using a diagnostic algorithm.
Patients with acute and chronic cholestasis can experience skin itching, impaired fat absorption and vitamin K deficiency. Chronic cholestasis can also be accompanied by hyperlipidemia and bone damage.