Extrahepatic cholestasis

Laboratory and image diagnosis

Abstract

Initial investigation of obstructive jaundice begins with anamnesis, physical examination and laboratory analysis. Image methods (ultrasound, computed tomography, magnetic ressonance) are indispensable nowadays for a correct evaluation. Other invasive procedures such as endoscopic or percutaneous cholangiography have well defined roles and need precise indication. Hepatic scintigraphy has a limited role but new methods including MRI-cholangiogram are increasingly used ducto great accuracy and low risk. The successful treatment of the jaundiced patient depends on a complete pre-operative assessment from surgeons, physicians and radiologists working together. Especialized units have been created with this aim.