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Cholestatic Liver Disease pp 1–20Cite as

Diagnosis of Cholestasis

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Part of the book series: Clinical Gastroenterology ((CG))

Abstract

An elevated serum alkaline phosphatase level is the hallmark of cholestasis. An abnormal gamma glutamyl transferase, 5′-nucleotidase, or liver alkaline phosphatase isoenzyme can confirm the source to be liver. Ultrasound is the most convenient way to differentiate between intrahepatic and extrahepatic cholestasis. Computed tomography or magnetic resonance imaging may be the initial test depending on the clinical setting. The level of obstruction can be identified by cholangiography: magnetic resonance cholangiography (or computed tomography cholangiogram if there are contraindications) for diagnosis alone; endoscopic retrograde cholangiography (or percutaneous transhepatic cholangiogram) if an intervention is anticipated. Endoscopic ultrasound and intraductal ultrasound may prove helpful in the evaluation of intraductal lesions. The choice of investigative test will depend on availability and local expertise in its use. Serologic studies and other disease markers can help make the diagnosis in an appropriate clinical setting or identify the next best diagnostic step. Liver biopsy often remains the best way to make or confirm the diagnosis and to stage chronic cholestatic disease.

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Authors and Affiliations

  1. Virginia Commonwealth University Medical Center, Richmond, VA

    Velimir A. Luketic MD

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  1. Velimir A. Luketic MD
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Editors and Affiliations

  1. Mayo Clinic, Rochester, MN

    Keith D. Lindor MD  & Jayant A. Talwalkar MD  & 

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© 2008 Humana Press Inc., Totowa, NJ

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Luketic, V.A. (2008). Diagnosis of Cholestasis. In: Lindor, K.D., Talwalkar, J.A. (eds) Cholestatic Liver Disease. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-59745-118-5_1

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  • DOI: https://doi.org/10.1007/978-1-59745-118-5_1

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-838-6

  • Online ISBN: 978-1-59745-118-5

  • eBook Packages: MedicineMedicine (R0)

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