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Infectious disease

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Treatment of jaundice

Alexey Portnov, medical expert
Last reviewed: 20.11.2021

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Actually jaundice, especially caused by an increase in direct bilirubin, does not serve as an object of therapeutic measures. In contrast, indirect bilirubin, being a fat-soluble compound, can have a damaging effect on certain structures of the nervous system with a high lipid content. It can occur when the concentration of indirect bilirubin in the blood serum is more than 257-340 μmol / l. In premature infants, with hypoalbuminemia, acidosis, the appointment of a number of drugs that compete in the blood for their association with albumin (sulfonamides, salicylates), bilirubin has a damaging effect even at a lower concentration. Treatment of jaundice, or rather, activities aimed at reducing the intensity of jaundice, usually carried only to newborns and young children with a high content of unconjugated bilirubin in the blood serum (Krigler-Nayyar syndrome, etc.). In acute viral hepatitis, the basis of treatment is basic therapy: diet, physical rest and detoxification therapy. Currently, with the fulminant course of HBV and OGS, it is recommended to prescribe antiviral therapy.

Extrahepatic obstruction of the biliary tract usually requires surgical intervention: endoscopic removal of stones from the ducts, placement of stents and drainage catheters for stenoses. In inoperable obturation, for example, as a result of a pancreatic tumor, a Fater nipple, as a palliative measure, the biliary tract is usually drained with stents inserted transversely or endoscopically. At present, endoscopic papillotomy with stone extraction has replaced laparotomy in patients with stones in the common bile duct.

With intrahepatic cholestasis (cholestatic form of viral hepatitis) prescribe drugs ursodeoxycholic acid, conduct sessions of plasmapheresis.

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