Cholestasis: causes

Causes of extrahepatic cholestasis

Extrahepatic cholestasis develops with mechanical obstruction of the main extrahepatic or major intrahepatic ducts.

1. Stones of the extrahepatic or major intrahepatic ducts.
2. The defeat of the pancreas in the head of the pancreas, which leads to compression of the common bile duct:
   1. tumor;
   2. pancreatitis;
   3. cyst;
   4. abscess.
3. Strictures of extrahepatic bile ducts, stenosis of the duodenal papilla.
4. Tumors of ducts.
   1. Primary (cholangiocarcinoma, tumor of the duodenal papilla).
   2. Metastatic.
5. Cysts of extrahepatic bile ducts.
6. Parasitic infections (opisthorchiasis, fascioliasis, ascariasis, clonorchiasis, echinococcosis).
7. Enlargement of lymph nodes in the gates of the liver.
8. The defeat of the duodenum (diverticulosis, Crohn's disease).
9. Aneurysm of the hepatic artery.

[1], [2], [3], [4]

The causes of intrahepatic cholestasis

With intrahepatic cholestasis, the pathological process is localized at the level of hepatocytes (hepatocellular cholestasis) or tubules (tubular cholestasis), with no obstruction of the main bile ducts.

1. Atresia (hypoplasia) of the peritoneal bile ducts.
2. Primary biliary cirrhosis of the liver.
3. Primary sclerosing cholangitis.
4. Cholangitis caused by infection (bacteria, cytomegalovirus, protozoa - cryptosporia).
5. Histiocytosis.
6. Cystic fibrosis is an obstruction of the intrahepatic bile ducts with very viscous bile.
7. Reaction of graft rejection.
8. Idiopathic duktopenia of adults.
9. Cholangiocarcinoma.
10. Hepatitis (acute, chronic) - a cholestatic variant
    1. Viral (especially caused by viruses of hepatitis A, C, G, cytomegalovirus, Epstein-Barr virus).
    2. Alcoholic.
    3. Autoimmune.
    4. Due to a deficiency of alpha1-antitrypsin.
11. Metabolic disorders - a deficiency of enzymes for the synthesis of bile acids ZbetaC ₂ 7-hydroxysteroid dehydrogenase and 04-3-oxosteroids-5beta-reductase.
12. Progressive intrahepatic familial cholestasis (Byler's syndrome).
13. Benign family recurrent cholestasis (Summerskill syndrome).
14. Benign cholestasis of pregnant women.
15. Drug cholestasis - is caused most often by the following drugs:
    
    1. psychotropic: chlorpromazine, aminazine, diazepam;
    2. antibacterial: erythromycin, ampicillin, oxacillin, nitrofurans, trimethoprim-sulfamethoxazole;
    3. hypoglycemic: chlorpropamide, tolbutamide;
    4. antiarrhythmic: Aymalin;
    5. immunosuppressants: cyclosporin A;
    6. anthelmintic: tibendazole;
    7. oral contraceptives: estrogens;
    8. anabolic steroids: retabolil, methandrostenolone;
    9. male sex hormones: testosterone, methyltestosterone.