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Jaundice and RUQ pain

Introduction

Jaundice and RUQ pain differential diagnosis are:

Classification of jaundice based on etiology Disease History and clinical manifestations Diagnosis
Lab Findings Other blood tests Other diagnostic
Family history Fever RUQ Pain Pruritis AST ALT ALK BLR Indirect BLR Direct Viral serology
Jaundice Hepatocellular Jaundice Hemochromatosis + – -/+ – ↑ ↑ ↑/N ↑/N N – Ferritin ↑ Liver biopsy
Wilson’s disease + – -/+ – ↑ ↑ N ↑/N N – Serum cerulloplasmin ↑ Liver biopsy
Alcoholic hepatitis – -/+ -/+ – ↑↑ ↑ N ↑/N N – – –
Cirrhosis -/+ -/+ -/+ – ↑ ↑ ↑/N ↑/N ↑/N -/+ Low platate Small liver on ultrasond
Cholestatic Jaundice Common bile duct stone -/+ – + + N N ↑ N ↑ – Dilated ducts on sono CT/ERCP
Hepatitis A cholestatic type – -/+ + + N N ↑ N ↑ + HAV- AB Abdominal ultrasound
EBV / CMV hepatitis – -/+ + + N N ↑ N ↑ + Positive serology
Primary biliary cirrhosis -/+ – -/+ + N/↑ N/↑ ↑ N ↑ – AMA positive Liver biopsy
Primary sclerosing cholangitis -/+ – -/+ + N/↑ N/↑ ↑ N ↑ – Beading on MRCP Liver biopsy
Pancreatic carcinoma + – -/+ – N/↑ N/↑ ↑ N ↑ – Mass on ultrasond CT scan for diagnosis