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Subjects/Surgery/Surgery
Surgery
medium
scissors Surgery

In a patient with obstructive jaundice, what is the possible explanation for a bilirubin level of 40 mg/dL?

A. Malignant obstruction
B. Complete obstruction of common bile duct
C. Renal failure
D. Liver failure

Explanation

Ans: C. Renal failure(Ref Zakim and Boyer s Hepatologv (2016)/p109; Bailey 25/e p1128, Textbook of hepatologv 6/e p20t).High bilirubin content:Causes of cholestatic jaundice (malignant obstruction, complete CBD obstruction).Presence of concomitant renal failure a Very high bilirubin beyond 30 mg/dL.Conjugated hyperbilirubinemia:Results from impaired intrahepatic bilirubin excretion or extrahepatic obstruction.Due to continued urinary excretion, maximum serum bilirubin levels plateau at approximately 500 mmol/L (30 Ing/dL) even with complete bile duct obstruction.Extreme hyperbilirubinemia:Levels higher than 500 mmol/L (30 mg/dL).Commonly indicates severe parenchymal liver disease in association with hemolysis (as in sickle cell anemia) or renal failure.

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