Jaundice

Jaundice is yellow discolouration of the skin, sclera and mucous membranes due to raised plasma bilirubin. Jaundice occurs due to an imbalance between the production and clearance of bilirubin and thus an understanding of bilirubin metabolism is required to evaluate a jaundiced patient. Jaundice can be classified as pre-hepatic, hepatic or post-hepatic according to the site of disruption of bilirubin metabolism. Following history, examination and initial blood tests, an abdominal ultrasound scan is usually the next investigation, with sequentially more invasive tests being undertaken as required. Jaundiced patients usually require management by a multidisciplinary team.