Cholestatic hepatitis - Causes, Symptoms, Diagnosis and Treatment

Cholestatic hepatitis - A disease in which the development is crucial obstruction of bile flow and the accumulation of its components in the liver. Clinically, the disease is manifested by itching, discomfort in the right hypochondrium region, intense jaundice, dyspepsia, enlargement of the liver and the emergence xanthelasma skin. In the diagnosis of primary importance are the general clinical and biochemical blood analysis with determination of liver function tests, ultrasound of the liver and gall bladder, pancreas ultrasound, MRI of the abdominal cavity. The therapy is aimed at improving the outflow of bile and normalization of body functions.

  • Reasons cholestatic hepatitis
  • Symptoms of cholestatic hepatitis
  • Diagnosis of cholestatic hepatitis
  • Treatment cholestatic hepatitis
  • Cholestatic hepatitis - treatment

  • Cholestatic hepatitis


    Hepatitis is a rather rare pathology, the pathogenesis of which is intrahepatic cholestasis with worsening excretory function of cells and damage to the ducts. The incidence of the disease is less than 10% of all hepatitis with chronic. Cholestatic hepatitis mostly occurs in older people. Despite its relatively low prevalence, disease difficult to treat due to the fact that it is not always possible to clearly establish its cause. The study of the etiology and pathogenesis, as well as the development of new therapies cholestatic hepatitis engaged in gastroenterology. Diagnosis and treatment of the disease carries a gastroenterologist and hepatologist, together with the surgeon.

    viral hepatitis B, C or other types of chronic. Also to intrahepatic cholestasis in some cases cause liver disease Ebstein-Barr virus, herpes, cytomegalovirus, mycoplasma infection. The cause of cholestatic hepatitis may be receiving various drugs, such as chlorpromazine, certain diuretics, antibiotics, anabolic steroids, contraceptives. The emergence of intrahepatic cholestasis is sometimes preceded by exposure to toxins, alcohol, poisons. Cholestatic hepatitis and develops against the background of endocrine diseases.

    Extrahepatic cholestasis may be due to obstruction of the large ducts. In this case, its possible causes are obstruction of the common bile duct stones, chronic calculous cholecystitis, chronic pancreatitis, cancer of the pancreatic head tumors and other organs of the hepatobiliary system. Against the background of cholestasis in the liver occurs destruction of the hepatocytes with subsequent organ dysfunction. In some cases, to establish the cause of the disease is not possible, that is treated as idiopathic cholestatic hepatitis.

    blood chemistry. At the biochemical study noted an increase in bilirubin levels due to direct fraction, increased transaminases, alkaline phosphatase (more than 5 times), gamma glutamintransferazy and cholesterol. It is also possible to determine the increased amount of phospholipids in blood, B-lipoprotein cholesterol and bile acids. To confirm the viral etiology of the disease is carried out research of specific markers by ELISA and PCR. A typical serological marker of intrahepatic cholestasis is the definition of mitochondrial antibodies.

    From instrumental methods necessarily holding ultrasound of the liver and gall bladder. Ultrasound examination revealed signs of chronic hepatitis. Ultrasound of the biliary tract, gall bladder and pancreas allows to confirm or rule out extrahepatic cholestasis. In the presence of difficulties in the diagnosis of cholestasis is conducted retrograde cholangiopancreatography, percutaneous transhepatic cholangiography or cholecystography that can detect stones in the bile ducts in those cases where they are not visible on ultrasound. Modern non-invasive methods to identify the causes of cholestatic hepatitis are MR cholangiopancreatography and MR hepatobiliary zone. To study the morphological changes can be performed hepatic biopsy, although it did not play a decisive role in the diagnosis of cholestasis.

    open cholecystectomy, resection of the head of the pancreas, bile duct stone extraction with RPHG, endoscopic balloon dilatation of the sphincter of Oddi, and so on.

    Prevention of the disease is reduced to the cessation of intake of alcohol and other hepatotoxic substances, as well as timely treatment of liver disease. With the right treatment and the elimination of causes of cholestasis, cholestatic hepatitis, the prognosis for the whole favorable.