extrahepatic biliary tract obstruction

Last edited 05/2019 and last reviewed 01/2023

Extrahepatic cholestasis results from the mechanical obstruction to large bile ducts outside the liver or within the porta hepatis.

The liver is enlarged and the intra-hepatic bile ducts widely dilated. The bile ducts proliferate in the portal zones. Infection of the bile above the obstruction leads to cholangitis; the ducts contain pus and may be surrounded by small abscesses.

The biochemical derangement is reinforced by clinical symptoms and signs:

  • pale stool - no bilirubin reaching gastrointestinal tract for conversion to stercobilin
  • dark orange urine - reflux of conjugated bilirubin into blood and excretion in urine