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Jaundice, Emergency Medicine

Andrew K. Chang and Albert Izzo Reviewed 06/2017
 


Basics

Description

Yellow pigmentation of tissues and body fluids due to hyperbilirubinemia, usually present at levels of >2.5 mg/dL 

Etiology

  • Unconjugated (indirect) hyperbilirubinemia: Unconjugated ...

Diagnosis

Signs and Symptoms

History

  • Cholestasis:

    • Pruritus

    • Pale stools

    • Dark urine

  • Malignancy:

    • Anorexia

    • Weight loss

    • Malaise

  • Abdominal pain

Physical Exam

  • Icterus of sclera and tongue base (levels >2.5 mg/dL)

  • Righ...

Treatment

Initial Stabilization/Therapy

  • Isotonic IV fluid therapy if dehydrated

  • Toxic-appearing patients:

    • Supplemental oxygen, cardiac monitoring

    • Nasogastric suction and bladder catheterization

Ed Treatment/Procedures

Follow-Up

Disposition

Admission Criteria

  • Bacterial cholangitis

  • Intractable pain

  • Intractable emesis

  • Associated pancreatitis

  • Elevated PT

Discharge Criteria

  • No evidence of infection (evaluate as outpatient)

  • Toler...

Additional Reading

  • Addley  J, Mitchell  RM. Advances in the investigation of obstructive jaundice. Curr Gastroenterol Rep.  2012;14:511–519

  • Maisels  MJ, McDonagh  AF. Phototherapy for neonatal jau...

Codes

ICD9

  • 277.4 Disorders of bilirubin excretion

  • 774.6 Unspecified fetal and neonatal jaundice

  • 782.4 Jaundice, unspecified, not of newborn

ICD10

  • E80.6 Other disorders of bilirubin metabolism

  • P59.9 Neonatal...

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