What is the Difference Between Intrahepatic and Extrahepatic Cholestasis?

Cholestasis is a condition that affects the flow of bile from the liver and can be classified into intrahepatic or extrahepatic cholestasis, depending on the level of obstruction to bile flow.

Intrahepatic cholestasis is related to liver disease and can be caused by various factors, including:

• Alcoholic liver disease
• Lymphoma
• Tuberculosis
• Viral hepatitis
• Genetic defects

Intrahepatic cholestasis can also occur late in pregnancy, potentially causing severe complications for the baby.

Extrahepatic cholestasis results from a condition outside the liver and can be caused by:

• Tumors in or near the bile ducts
• Cysts
• An inflamed pancreas
• Gallstones in a bile duct

The symptoms of intrahepatic and extrahepatic cholestasis are similar and include:

• Jaundice (yellowing of the skin and eyes)
• Itchy skin
• Dark urine
• Light-colored stool
• Abdominal pain
• Fatigue
• Nausea
• Poor digestion
• Vomiting

Diagnosing cholestasis involves a review of the patient's symptoms and medical history, as well as blood tests to check liver enzymes for signs of cholestasis. Additional tests, such as an ultrasound, MRI, or liver biopsy, may be needed to confirm the diagnosis.

Comparative Table: Intrahepatic vs Extrahepatic Cholestasis

Intrahepatic and extrahepatic cholestasis are two different types of cholestasis, which is a condition characterized by the slowing down or obstruction of bile flow. The main differences between intrahepatic and extrahepatic cholestasis are summarized in the table below:

Intrahepatic cholestasis is due to an impairment of bile formation, while extrahepatic cholestasis is due to an impedance to bile flow after its formation. Intrahepatic cholestasis can be caused by various factors, including primary biliary cirrhosis, primary sclerosing cholangitis, drugs and toxins, sepsis, malignancy-granulomatous liver disease, pregnancy-related complications, genetic disorders, and total parenteral nutrition-associated cholestasis. In contrast, extrahepatic cholestasis is typically caused by blockages of bile ducts, such as gallstones, cysts, and tumors.