Jaundice

Jaundice is the result of bilirubin binding to elastin in the skin, mucous membranes and sclerae and tends to have a greenish tinge . The same colour is seen in resolving bruises. Conjugated hyperbilirubinaemia results from impaired uptake (systemic illness, drugs), reduced secretion (liver disease) or biliary obstruction. Stigmata of chronic liver disease may or may not be present. Cholestatic jaundice also results in dark urine and lightly coloured stools. It may be associated with generalised pruritus due to elevated bile acids. There is no excessive bilirubin in urine with unconjugated hyperbilirubinaemia.