Cholestasis Symptoms | Cholestasis Jaundice, Obstetric Cholestasis Symptoms

What Is Cholestasis

Cholestasis is obstruction of the cystic duct of the gallbladder causing inflammation of the gallbladder (cholecystitis).

Symptoms of Cholestasis

  • Majority attacks of acute cholecystitis occur in patients who have history of chronic cholecystitis and cholelithiasis (gallbladder stones).
  • Acute inflammation can occur at any age bit the highest incidence is between 4th and 5th decades.
  • The onset is usually sudden. Often it follows a heavy, fatty meal. This is due to vigorous attempts of the gallbladder to empty its contents.
  • Acute cholestasis presents as an acute abdominal emergency.
  • Agonizing pain is complained of in the right upper quadrant of the abdomen and may be referred back to the inferior angle of the scapula or in the inter-scapular area or to the right shoulder when the diaphragm is irritated by the inflammatory process.
  • Persistent pain in the area of the gallbladder is present in almost every case. Pain probably first caused by gallbladder distension and finally by inflammation of the gallbladder and adjacent peritoneal surfaces.
  • Persistence and severity of pain serve to distinguish acute cholecystitis from gallbladder colic.
  • In case of the former pain may lasts for several days, but in case of the latter pain rarely lasts for more than a few hours.
  • Nausea and vomiting are important symptoms and are seen in about 70% of cases. These are reflux phenomenon due to rapid rise in gallbladder pressure.
    Sometimes patient may induce vomiting in an attempt to gain relief.

Signs Of Cholestasis

  • Pyrexia (fever)
    • It is regular feature of acute cholestasis. It may be absent only in the elderly and in patients who take steroids or non-steroidal anti-inflammatory drugs or commonly called pain-killers.
  • cholestasis Jaundice
    • It is present in is present due to obstruction of the cystic duct and entry of the bile pigments into the circulation through the damaged gall-bladder mucosa.
    • Jaundice may also occur from gallbladder sphincter spasm induced by the adjacent inflammatory process.
  • Tenderness
    • In the right upper quadrant there is tenderness which is a reliable finding.
      In about 1/2 the patients there may be rigidity. Rebound tenderness may also be present.
  • Murphy’s Sign
    • During deep palpation of the right upper quadrant, the patient is asked to take deep breath in and out.
    • Patient complains of acute pain during deep inspiration with arrest of inspiration when tender inflamed gallbladder comes down and touches the palpating finger. This is Murphy’s sign.
    • A mass in the region of the gallbladder is palpable in 40% of cases.