Jaundice has a broad differential. It can result from a multitude of hepatic and hematologic pathologies, including obstructive process, hepatocellular process, or hemolytic/hematopoietic process.
The history and physical examination are particularly important in narrowing the differential for jaundice.
Studies have shown that clinical estimates of serum bilirubin have shown poor interrelater reliability. Skin examination alone is insufficient in judging serum bilirubin levels.
Most Important References
Lalani T, Couto CA, Rosen MP, et al. ACR appropriateness criteria jaundice. J Am Coll Radiol. 2013;10(6):402-409. (Consensus statement) DOI: https://doi.org/10.1016/j.jacr.2013.02.020
Pasanen PA, Partanen KP, Pikkarainen PH, et al. A comparison of ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the differential diagnosis of benign and malignant jaundice and cholestasis. Eur J Surg. 1993;159(1):23-29. (Prospective; 220 patients) https://inis.iaea.org/search/search.aspx?orig_q=RN:25018170
Kiewiet JJ, Leeuwenburgh MM, Bipat S, et al. A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis. Radiology. 2012;264(3):708-720. (Review) DOI: https://doi.org/10.1148/radiol.12111561
Williams EJ, Green J, Beckingham I, et al. Guidelines on the management of common bile duct stones (CBDS). Gut. 2008;57(7):1004-1021. (Consensus guideline) DOI: http://dx.doi.org/10.1136/gut.2007.121657
Smilkstein MJ, Knapp GL, Kulig KW, et al. Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985). N Engl J Med. 1988;319(24):1557-1562. (Retrospective; 2540 patients) DOI: http://dx.doi.org/10.1056/NEJM198812153192401
Wolf SJ, Heard K, Sloan EP, et al. Clinical policy: critical issues in the management of patients presenting to the emer-gency department with acetaminophen overdose. Ann Emerg Med. 2007;50(3):292-313. (Practice guideline) DOI: https://doi.org/10.1016/j.jen.2008.02.004