Jaundice: applying lessons from physiology

Jaundice is a common symptom as well as a sign in medical and surgical gastroenterology practice. Understanding the pathway of bilirubin metabolism helps in a logical approach to the pre-hepatic, hepatocellular and cholestatic mechanisms of development of jaundice. Clinical evaluation and easily available blood tests in combination with non-invasive imaging should establish the diagnosis in most cases. Further management may require advanced and invasive techniques, the choice of which should be based on the benefit–risk ratio in a particular clinical scenario, access to these techniques and local expertise.