What is the Difference Between Hepatocellular and Obstructive Jaundice

The key difference between hepatocellular and obstructive jaundice is that hepatocellular jaundice is due to a dysfunction of hepatic cells, while obstructive jaundice is due to a narrowed or blocked bile duct or pancreatic duct.

Jaundice is due to high levels of bilirubin in the blood. Bilirubin is the normal breakdown product of the heme of red blood cells. Under normal conditions, bilirubin undergoes conjugation within the liver, making it more water-soluble. Then, it is excreted via the bile into the gastrointestinal tract, where it is eliminated in feces as urobilinogen and stercobilin. Additionally, 10% of urobilinogen is reabsorbed into the bloodstream. Jaundice typically occurs when there is a disruption in this pathway. There are three types of jaundice: pre-hepatic, hepatocellular, and post-hepatic (obstructive).

CONTENTS

1. Overview and Key Difference
2. What is Hepatocellular Jaundice
3. What is Obstructive Jaundice
4. Similarities – Hepatocellular and Obstructive Jaundice
5. Hepatocellular vs. Obstructive Jaundice in Tabular Form
6. Summary – Hepatocellular vs. Obstructive Jaundice

What is Hepatocellular Jaundice?

Hepatocellular jaundice is the most common type of jaundice. It occurs when bilirubin is unable to leave liver cells due to the dysfunction of liver cells. In this case, the kidneys cannot remove bilirubin from the body. Hepatocellular jaundice is usually caused by liver failure, liver disease (cirrhosis), hepatitis (inflammation of the liver), or due to taking certain types of medications. The symptoms of hepatic jaundice may include loss of appetite, nose bleeding, skin itching, weakness, abnormal weight loss, swelling of the abdomen or legs, dark urine or pale feces, muscle pain or joint pain, fever, feeling sick, and throwing up. The risk factors for this type of jaundice include drug use, drinking a lot of alcohol over a period, using medication such as acetaminophen or heart medications, and previous infections in the liver.

Moreover, hepatocellular jaundice can be diagnosed through a urinalysis, blood tests, imaging tests such as an MRI or ultrasound, and an endoscopy. Treatment options for hepatocellular jaundice may include plenty of rest, low protein diet, quitting smoking, using beta blockers, intravenous (IV) antibiotics, antiviral medications, vaccination, bile acids to help with digestion, taking bile lowering medication, taking antihistamines like diphenhydramine for itching, liver transplant, ventilators for breathing difficulties, dialysis for kidney damage, chemotherapy or radiation to kill cancer cells in the liver, and partial liver resection.

What is Obstructive Jaundice?

Obstructive jaundice is a less common type of jaundice. It occurs when bilirubin cannot be drained properly into bile ducts or the digestive tract due to a blockage. Obstructive jaundice is caused by gallstones, pancreatic cancer, pancreatitis, bile duct cancer, and biliary atresia (a genetic condition). The symptoms of obstructive jaundice may include feeling sick, throwing up, dark urine or pale stool, pain in the abdomen, diarrhea, abnormal weight loss, itching in the skin, abdominal swelling, and fever. The risk factors for this condition include being overweight, having a low-fiber diet, having diabetes mellitus, having a family history, being female, aging, smoking, drinking a lot of alcohol, having previous inflammation or infection, and being exposed to industrial chemicals.

Moreover, obstructive jaundice can be diagnosed through physical examination, a urinalysis, a complete blood test, a liver function test, imaging tests such as MRI, ultrasound, or HIDA scan, and an endoscopy. Furthermore, treatment options for obstructive jaundice may include changing the diet to stop producing gallstones, removing gallstones by surgery, medications for gallstones, surgery to remove cancerous tissue or the whole pancreas, radiation or chemotherapy to kill cancer cells, surgery to remove bile ducts, parts of liver and pancreas, liver transplant, intravenous (IV) fluids or pain medication, and Kasai procedure to remove and replace ducts.

What are the Similarities Between Hepatocellular and Obstructive Jaundice?

• Hepatocellular and obstructive jaundice are two different types of jaundice.
• Both types may have similar symptoms, such as feeling sick, weakness, throwing up, dark urine or pale stool, abdominal pain, abnormal weight loss, skin itching, etc.
• Both types can be diagnosed through a urinalysis, blood tests, imaging tests, and endoscopy.
• They are treated through specific lifestyle changes, medications, chemotherapy, radiation, and surgeries.

What is the Difference Between Hepatocellular and Obstructive Jaundice?

Hepatocellular jaundice is due to the dysfunction of hepatic cells, while obstructive jaundice is due to a narrowed or blocked bile duct or pancreatic duct. Thus, this is the key difference between hepatocellular and obstructive jaundice. Furthermore, hepatocellular jaundice is the most common type, while obstructive jaundice is a less common type of jaundice.

The infographic below presents the differences between hepatocellular and obstructive jaundice in tabular form for side-by-side comparison.

Summary – Hepatocellular vs. Obstructive Jaundice

Jaundice is a serious medical condition that makes the skin and the whites of the eyes a yellowish color. Jaundice occurs when too much bilirubin builds up in the blood. Bilirubin is a yellowish pigment produced by hemoglobin breakdown. Hepatocellular and obstructive jaundice are two different types of jaundice. Hepatocellular jaundice is the most common type of jaundice caused by damaged liver tissue, while obstructive jaundice is a less common type caused by the blockage of the bile duct or digestive duct. So, this summarizes the difference between hepatocellular and obstructive jaundice.

Reference:

1. “Hepatocellular Jaundice.” Encyclopædia Britannica.
2. “Obstructive Jaundice.” An Overview | ScienceDirect Topics.

Image Courtesy:

1. “NAFLD liver progression” By Signimu – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Obstructivebiliarydilation2” By James Heilman, MD – Own work (CC BY-SA 3.0) via Commons Wikimedia