Causes of Jaundice

QUESTION: We visited a friend in the hospital who is distressed not only by
his condition, but by the conflicting information he has been given. He is
all yellow, and was told at first that it was a liver infection. Now he is
being told it is an obstruction and that he must have surgery. Is there
any way you can untangle this situation for us?
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ANSWER: Your "yellowed" friend is displaying the effects of a condition
called jaundice, which occurs when pigments found normally in the bile find
their way into the blood stream and thus to the skin. That's causing the
yellow color, but it only indicates that a disease process is going on without
specifically telling us which one. Jaundice is caused by a large number of
diseases, certainly the most common being viral hepatitis. Most physicians
would rank it the number 1 possible cause of jaundice, and then begin the
difficult process of determining the exact reason for the jaundice. Besides a
variety of infections, such as malaria, mononucleosis, yellow fever and
others, the yellowing condition may be caused by drugs used to control other
medical conditions. More common, though, are those conditions which block the
flow of bile from the liver to the portion of the small intestines known as
the duodenum. These situations range from blockage by gall stones in the
small ducts through which the bile normally flows to the closing of these
small and delicate tubes by cancerous growths of the pancreas and of the ducts
themselves. We can use blood tests to distinguish between this type of
jaundice, called obstructive jaundice, and the type caused by infections.
X-ray procedures help to pinpoint the exact location of the blockage, and then
it is up to the surgeon to remove the cause. This surgery can be long and
difficult, and your friend is entitled to a most careful explanation of all
that is involved.