Diagnosis

• Urinalysis — unconjugated bilirubin does not appear in the urine.

• Measurement of conjugated and unconjugated bilirubin — conjugated bilirubin predominates in cholestatic jaundice, unconjugated bilirubin in pre-hepatic jaundice, and a mixed picture is often seen in hepatocellular jaundice.

• Plasma alkaline phosphatase is usually markedly elevated in obstructive jaundice while prothrombin times, aspartate transaminase and alanine aminotransferase are elevated in hepatocellular jaundice.

• Ultrasound or CT scan will diagnose extrahepatic biliary obstruction.

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