Causes of postoperative jaundice or hepatic dysfunction

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Pre hepatic/ Haemolytic/ Bilirubin overload

  • Massive blood transfusion

  • Transfusion reaction

  • Haemolytic anaemia

  • Surgical trauma with multiple injuries

  • Prosthetic heart valve

  • Cardiopulmonary bypass


Hepatocellular injury

  • Exacerbation of preexisting liver disease

  • Hepatic ischemia: hypotension, hypovolemia, cardiac failure

  • Hypoxia

  • Drug-induced - Halothane 

  • Septicaemia


Intrahepatic Cholestasis 

  • Viral hepatitis

  • Alcoholic hepatitis

  • Cholestasis in pregnancy 

  • TPN

  • Steroid, OCP


Extra hepatic cholestasis

  • Biliary obstruction, stricture, injury, leak
  • Pancreatitis


Patients with severe cholestasis may have an elevated prothrombin time, which may respond to vitamin K.

Prolonged cholestasis may lead to malabsorption of fats and other fat-soluble vitamins, and thus nutritional evaluation may be required.

INR should be monitored until normalization unless another explanation such as coagulopathy or medication is provided.

Comments

  1. DR Himanshu YadavMarch 5, 2022 at 2:17 AM

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    ReplyDelete
    Replies
    1. Anaesthesia student March 9, 2022 at 9:09 PM

      Thank you DR Himanshu Yadav for your kind comment. Please email us about some topic you are interested in, so that we can share common interest.

      Delete

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