Clinical Approach to Jaundice

Abstract

Jaundice is still a common clinical problem. The increasing availability of laboratory and invasive and noninvasive diagnostic radiologic techniques has not altered the necessity of a logical and organized diagnostic approach to the problem. Drs. Dusol and Schiff appropriately emphasize the importance of bilirubin fractionation as an essential point of departure, since it differentiates disorders of bilirubin transport from hepatocellular or biliary disorders.

Obtaining a careful drug history is emphasized. With the list of potentially icterogenic drugs growing rapidly, it seems rational to discontinue any medication a jaundiced patient can temporarily do without. Surprisingly, the jaundice may abate? more importantly, you may determine that the patient no longer requires the medication.—AR