Copyright 2008
Definition
Cholestasis defined functionally as impaired flow of bile through the biliary tree. This impaired flow causes an increase in bilirubin levels, which is conjugated to direct bilirubin, which at elevated serum levels causes marked pruritis.
Common causes of drug-induced cholestasis are: steroids, estrogens, even antipsychotic medications.
Diagnostic hallmarks are an increased alkaline phosphatase, and conjugated bilirubin levels.
Cholestatis as an entity is further characterized as being intrahepatic or extra hepatic.
Thin Sludge |
| 11921.8b05b039.8s gallbladder distended enlarged dilated fluid fluid level gravity specific gravity sediment sludge cholestasis stasis Davidoff art copyright 2008 |
Tumefactive Bile |
| 11921.8b05b043..8sb01 gallbladder distended tumefactive bile crank case oil thick sludge enlarged dilated fluid fluid level gravity specific gravity sediment sludge black cholestasis stasis Davidoff art copyright 2008 |
Sludge – Almost Fluid |
| 78365c.8s gallbladder sludge cholestasis fluid fluid level USscan ultrasound Courtesy Ashley Davidoff MD copyright 2008 |
Sludge – Almost Fluid |
| 1004BH~1.8s gallbladder cholestasis fluid fluid level free fluid ascites USscan Ultrasound CourtesyPhilips Medical Systems copyright 2008 |
Sludge – Almost Fluid Hyperdense |
| 82010c01.8s gallbladder distended fluid fluid level sludge thickened bile cholestasis CTscan Courtesy Ashley DAvidoff MD copyright 2008 |
Sludge – and a Stone |
| 04740.8s gallbladder cholestasis fluid fluid level cholelithiasis shadowing stone thickening of gallbladder fossa GBF USscan Ultrasound Courtesy Ashley Davidoff MD copyright 2008 |
Cholestasis – Fluid Stage |
| 17087c.8s gallbladder cholestasis fluid fluid level gravity specific gravity dilated enlarged gallbladder sediment supernatant CBD stone MRI T1 weighted with gadolinium T2 weighted thick walled enhancing wall watery sludge Courtesy Ashley Davidoff MD copyright 2008 |
Acalculous Cholecystitis Crankcase Oil |
| 11921.8b05b043.8s gallbladder distended tumefactive bile thick sludge enlarged dilated fluid fluid level gravity specific gravity sediment sludge cholestasis stasis inflammation acalculous cholecystitis Davidoff art copyright 2008 |
Wall Rupture |
| 11921.8b05b043..8kb03 gallbladder distended tumefactive bile crank case oil thick sludge enlarged dilated fluid fluid level gravity specific gravity sediment sludge black cholestasis stasis wall inflammation acalculous cholecystitis complicated by perforation Davidoff art copyright 2008 |
Wall Rupture Focal Peritonitis |
| 11921.8b05b043.8b05s gallbladder distended tumefactive bile crank case oil thick sludge enlarged dilated fluid fluid level gravity specific gravity sediment sludge black cholestasis stasis wall inflammation acalculous cholecystitis complicated by perforation Davidoff art copyright 2008 |
Rupture with Bile Peritonitis |
| 11921.8b05b046.8b05 gallbladder distended tumefactive bile crank case oil thick sludge enlarged dilated fluid fluid level gravity specific gravity sediment sludge black cholestasis stasis wall inflammation acalculous cholecystitis complicated by perforation and bile peritonitis Davidoff art copyright 2008 |