history

Last reviewed 01/2018

Important points in a history concerning jaundice include:

• duration of illness:
• short history, preceding nausea, anorexia - suggests hepatitis
• cholestatic jaundice develops slowly, usually with persistent pruritus
• pyrexia, fevers, rigors - suggests cholangitis associated with gallstones or biliary stricture

• family history - congenital hyperbilirubinaemia, hepatitis, gallstones

• recent community outbreak of jaundice - suggests hepatitis A

• recent consumption of shellfish - suggests hepatitis A

• note recent travel to areas where hepatitis is endemic

• male homosexuality, recent injections - intravenous drug abuse, blood tests, tuberculin testing - increased risk of hepatitis B

• recent blood or plasma transfusion - increased risk of hepatitis C in developed countries; of hepatitis B in developing countries

• alcohol consumption - may complain of morning nausea, anorexia, diarrhoea, right upper quadrant pain

• recent surgery:
• jaundice following biliary tract surgery may indicate residual calculi
• may be due to anaesthesia e.g. halothane

• rarely the patient may complain that everything has a yellow tinge - xanthopsia