Biliary Secretory Failure in Man
Authors: SHEILA SHERLOCK
Journal: Annals of Internal Medicine (1966)

Article1 September 1966Biliary Secretory Failure in ManThe Problem of CholestasisSHEILA SHERLOCK, M.D., F.R.C.P., F.R.C.P.E., F.A.C.P. (HON.)SHEILA SHERLOCK, M.D., F.R.C.P., F.R.C.P.E., F.A.C.P. (HON.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-3-397 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe diagnosis of the type and cause of jaundice is usually an easy clinical exercise. The majority of patients will be suffering from hepatocellular jaundice due to acute viral hepatitis or cirrhosis or surgical cholestatic jaundice due to cholelithiasis or carcinoma of the pancreas or liver. Such conditions will be obvious to most junior physicians. There remains a proportion in which difficulty arises, and this is especially so when the distinction between medical and surgical jaundice is required. This paper describes a group of patients in whom surgical jaundice is simulated, although the origin lies within the liver. An anatomical...References1. YAMAMOTOSKANDERBERGZIPURSKYISRAELS TJALG: The early appearing bilirubin: evidence for two components. J. Clin. Invest. 44: 31, 1965. CrossrefMedlineGoogle Scholar2. ROBINSONOWENFLOCKSCHMID SHCAEVR: Bilirubin formation in the liver from nonhemoglobin sources. Experiments with isolated perfused rat liver. Blood 26: 823, 1965. CrossrefMedlineGoogle Scholar3. ELIAS H: Embryology, histology and anatomy of the biliary system, in The Biliary System, edited by TAYLOR, W. Blackwell, Oxford, 1965. Google Scholar4. WHEELER HO: The function of the biliary tract, in Progress in Liver Diseases, edited by POPPER, H., SCHAFFNER, F. Grune & Stratton, New York and London, 1965. CrossrefGoogle Scholar5. RAIA S: Histochemical demonstration of conjugated and unconjugated bilirubin using a modified diazo-reagent. Nature (London) 205: 304, 1965. CrossrefMedlineGoogle Scholar6. OHKITAIWASAKIDONOMAETATSUMI HRTS: Electron microscopic studies of bile canaliculi. Kanzo 3:9, 1961. Google Scholar7. POPPERSCHAFFNERRUBINBARKAPARONETTO HFETF: Mechanisms of intrahepatic cholestasis in drug-induced hepatic injury. Ann. N. Y. Acad. Sci. 104: 988, 1963. CrossrefGoogle Scholar8. GOLDFISCHERARIASESSNERNOVIKOFF SIMEAB: Cytochemical and electron microscopic studies of rat liver with reduced capacity to transport conjugated bilirubin. J. Exp. Med. 115: 467, 1962. CrossrefMedlineGoogle Scholar9. JÉZÉQUEL AM: Dégénérescence myélinique des mitochondries de foie humain dans un épithélioma du choledoque et un ictère viral. J. Ultrastruct. Res. 3: 210, 1959. CrossrefMedlineGoogle Scholar10. STEINERCARRUTHERSKALIFAT JWJSSR: Disturbances of hydration of cells of rat liver in extrahepatic cholestasis. Virchow, Arch. Path. Anat. 336: 99, 1962. CrossrefMedlineGoogle Scholar11. DATTASHERLOCK DVS Cholestyramine for long term relief of the pruritus complicating intrahepatic cholestasis. Gastroenterology 50: 323, 1966. CrossrefMedlineGoogle Scholar12. OSBORNWOOTTONSILVASHERLOCK ECIDLCS: Serum-bile-acid levels in liver disease. Lancet 2: 1049, 1959. CrossrefMedlineGoogle Scholar13. CHIANDUSSIGREENESHERLOCK LSFS: Serum alkaline phosphatase in hepato-biliary and bone diseases. Clin. Sci. 22: 425, 1962. MedlineGoogle Scholar14. CAESARSHALDONCHIANDUSSIGUEVARASHERLOCK JSLLS: The use of indocyanine green in the measurement of hepatic blood flow and as a test of hepatic function. Clin. Sci. 21: 43, 1961. MedlineGoogle Scholar15. BILLINGWILLIAMSRICHARDS BHRTG: Defects in hepatic transport of bilirubin in congenital hyperbilirubinaemia: an analysis of plasma bilirubin disappearance curves. Clin. Sci. 27: 245, 1964. MedlineGoogle Scholar16. WATSONHOFFBAUER CJFW: The problem of prolonged hepatitis with particular reference to cholangiolitic type and to the development of cholangiolitic cirrhosis of the liver. Ann. Intern. Med. 25: 195, 1946. LinkGoogle Scholar17. SHALDONSHERLOCK SS: Virus hepatitis with features of prolonged bile retention. Brit. Med. J. 2: 734, 1957. CrossrefMedlineGoogle Scholar18. PHILLIPSDAVIDSON GBCS: Acute hepatic insufficiency of the chronic alcoholic: clinical and pathological study. Arch. Intern. Med. (Chicago) 94: 585, 1954 CrossrefGoogle Scholar19. BALLARDBERNSTEINFARRAR HMJT: Fatty liver presenting as obstructive jaundice. Amer. J. Med. 30: 196, 1961. CrossrefMedlineGoogle Scholar20. BECKETTLIVINGSTONEHILL AGAVKR: Acute alcoholic hepatitis. Brit. Med. J. 2: 1113, 1961. CrossrefMedlineGoogle Scholar21. SCHAFFNERLOEBELWEINERBARKA FAHAT: Hepatocellular cytoplasmic change in acute alcoholic hepatitis. JAMA 183: 343, 1963. CrossrefMedlineGoogle Scholar22. DATTASHERLOCKSCHEUER DVSPJ: Post-necrotic cirrhosis with features of cholestasis. Gut 4: 223, 1963. CrossrefMedlineGoogle Scholar23. WILLIAMSBILLING RBH: Action of steroid therapy in jaundice. Lancet 2: 392, 1961. CrossrefMedlineGoogle Scholar24. WHEELERMELTZERBRADLEY HOJISE: Biliary transport and hepatic storage of sulfobromophthalein sodium in the unanesthetized dog, in normal man and in patients with hepatic disease. J. Clin. Invest. 39: 1131, 1960. CrossrefMedlineGoogle Scholar25. COOKVELASCOSHERLOCK GCMS: Effect of corticosteroids on bromsulphalein metabolism in liver disease. In preparation, 1966. Google Scholar26. WERNERHANGERKRITZLER SCFMRA: Jaundice during methyl testosterone therapy. Amer. J. Med. 8: 325, 1950. CrossrefMedlineGoogle Scholar27. SCHAFFNERPOPPERPEREZ FHV: Changes in bile canaliculi produced by norethandrolone: electron microscopic study of human and rat liver. J. Lab. Clin. Med. 56: 623, 1960. MedlineGoogle Scholar28. ADLERCREUTZ H: Steroid induced icterus. Nord. Med. 72: 1004, 1964. MedlineGoogle Scholar29. ELLIOTTHENDRY AJJ: Cholestatic jaundice complicating pregnancy; recurrence after norethynodrel with ethinylestradiol (Enovid). Canad. Med. Ass. J. 92: 344, 1965. MedlineGoogle Scholar30. BOAKESCHADEMORRISSEYSCHAFFNER WCSSJFF: Intrahepatic cholestatic jaundice of pregnancy followed by Enovid-induced cholestatic jaundice; report of a case. Ann. Intern. Med. 63: 302, 1965. LinkGoogle Scholar31. FAWCETTPEDERSON JWDL: Oral contraceptives and liver damage. Brit. Med. J. 2: 755, 1964. CrossrefGoogle Scholar32. IKONEN E: Jaundice in late pregnancy. Acta. Obstet. Gynec. Scand. 43 (suppl. 5): 1, 1964. Google Scholar33. LARSSON-COHNSTENRAM UU: Jaundice during treatment with oral contraceptive agents; report of two cases. JAMA 193: 422, 1965. CrossrefMedlineGoogle Scholar34. BARNES GF: Jaundice in a patient taking more than one compound tablet. Brit. Med. J. 1: 108, 1965. Google Scholar35. THULINNERMARK KEJ: Seven cases of jaundice in women taking an oral contraceptive, Anovlar. Brit. Med. J. 1: 584, 1966. CrossrefMedlineGoogle Scholar36. OLDERHAUSENEGGSTEINDOLDKNORR HFMUK: Intrahepatic cholestasis with jaundice after taking contraceptive steroids. German Med. Monthly 11: 24, 1966. MedlineGoogle Scholar37. CULBERGLUNDSTRÖMSTENRAM GRU: Jaundice during treatment with an oral contraceptive, Lyndiol. Brit. Med. J. 1: 695, 1965. CrossrefMedlineGoogle Scholar38. HOLZBACHSANDERS RTJH: Recurrent intrahepatic cholestasis of pregnancy; observations on pathogenesis. JAMA 195: 542, 1965. CrossrefGoogle Scholar39. SOTANIEMIKREUSSCHEININ EKEFM: Oral contraceptives and liver damage. Brit. Med. J. 2: 1264, 1964. CrossrefMedlineGoogle Scholar40. THORLING L: Jaundice in pregnancy: a clinical study. Acta. Med. Scand. (suppl. 302), 1955. Google Scholar41. SVANBORGOHLSSON AS: Recurrent jaundice of pregnancy: a clinical study of twenty-two cases. Amer. J. Med. 27: 40, 1959. CrossrefMedlineGoogle Scholar42. HAUSHEERLAUER HJDJ: Recurrent jaundice of pregnancy. Report of a case. New Eng. J. Med. 267: 1300, 1962. CrossrefMedlineGoogle Scholar43. COMBESSHIBATAADAMSMITCHELLTRAMELL BHRBDV: Alterations in sulfobromophthalein sodium-removal mechanisms from blood during normal pregnancy. J. Clin. Invest. 42: 1431, 1963. CrossrefMedlineGoogle Scholar44. MUELLERKAPPAS MNA: Estrogen pharmacology. 1. The influence of estradiol and estriot on hepatic disposal of sulfobromophthalein (BSP) in man. J. Clin. Invest. 43: 1905, 1964. CrossrefMedlineGoogle Scholar45. KLEINERKRESCHARIAS GJLIM: Studies of hepatic excretory function. II. The effect of norethynodrel and mestranol on bromsulfalein sodium metabolism in women of childbearing age. New Eng. J. Med. 273: 420, 1965. CrossrefMedlineGoogle Scholar46. KATZVELASCOREYES RMH: Jaundice during treatment with contraceptive pills. Gastroenterology 50: 853, 1966. Google Scholar47. BROWN BL: Primary intrahepatic cholestasis due to Hodgkin's disease with response to adrenocorticotropin. Ohio Med. J. 55: 1384, 1959. MedlineGoogle Scholar48. BOURONCLEOLDVAZQUES BAJWAG: Pathogenesis of jaundice in Hodgkin's disease. Arch. Intern. Med. (Chicago) 110: 872, 1962. CrossrefMedlineGoogle Scholar49. JUNIPER K: Prolonged severe obstructive jaundice in Hodgkin's disease. Gastroenterology 44: 199, 1963. CrossrefMedlineGoogle Scholar50. LEVITANDIAMONDCRAVER RHDLF: Jaundice in Hodgkin's disease. Amer. J. Med. 30: 99, 1961. CrossrefMedlineGoogle Scholar51. SHERLOCK S: Hepatic reactions to therapeutic agents. Ann. Rev. Pharmacol. 5: 429, 1965. CrossrefMedlineGoogle Scholar52. SUMMERSKILLWALSHE WHJM: Benign recurrent intrahepatic "obstructive" jaundice. Lancet 2: 686, 1959. CrossrefMedlineGoogle Scholar53. WILLIAMSCARTTERSHERLOCKSCHEUERHILL RMSPJKR: Idiopathic recurrent cholestasis: a study of the functional and pathological lesions in four cases. Quart. J. Med. 33: 387, 1964. MedlineGoogle Scholar54. SUMMERSKILL WH: The syndrome of benign recurrent cholestasis. Amer. J. Med. 38: 298, 1965. CrossrefMedlineGoogle Scholar55. KÜHN HA: Intrahepatic cholestasis in two brothers. German Med. Monthly. 8: 185, 1963. Google Scholar56. TYGSTRUP N: Intermittent possibly familial intrahepatic cholestatic jaundice. Lancet 1: 1171, 1960. CrossrefMedlineGoogle Scholar57. TYGSTRUP N: Intermittent benign cholestasis. Personal communication, 1966. Google Scholar58. AHRENSPAYNEKUNKELEISENMENGERBLONDHEIM EHMAHGWJSH: Primary biliary cirrhosis. Medicine (Balt.) 29: 199, 1950. CrossrefGoogle Scholar59. SHERLOCK S: Primary biliary cirrhosis (chronic intrahepatic obstructive jaundice). Gastroenterology 37: 574, 1959. CrossrefMedlineGoogle Scholar60. RUBINSCHAFFNERPOPPER EFH: Primary biliary cirrhosis. Chronic non-suppurative obstructive cholangitis. Amer. J. Path. 56: 387, 1965. Google Scholar61. KLIONSCHAFFNER FMF: Electron microscopic observations in primary biliary cirhosis. Arch Path (Chicago) 81: 152, 1966. MedlineGoogle Scholar62. WALKERDONIACHROITTSHERLOCK JGDIS: Serological tests in the diagnosis of primary biliary cirrhosis.. Lancet 1: 827, 1965. CrossrefMedlineGoogle Scholar63. DONIACHROITTWALKERSHERLOCK DIJGS: Immunological tests in primary biliary cirrhosis. Clin. Exp. Immun. 1: 237, 1966. MedlineGoogle Scholar64. SMETANAEDLOWGLUNZ HFJBPR: Neonatal jaundice. A critical review of persistent obstructive jaundice in infancy. Arch Path (Chicago) 80: 553, 1965. MedlineGoogle Scholar65. STOWENS D: Congenital biliary atresia. Ann. N. Y. Acad. Sci. 111: 337, 1963. CrossrefMedlineGoogle Scholar66. BAKERHARRIS DHRC: Congenital absence of the intrahepatic bile ducts. Amer. J. Roentgen. 91: 875, 1964. Google Scholar67. SMITHLOE MPRH: Sclerosing cholangitis. Review of recent case reports and associated diseases and four new cases. Amer. J. Surg. 110: 239, 1965. CrossrefMedlineGoogle Scholar68. WENGERGINGRICHMEDELOFF JGWJ: Sclerosing cholangitis—a manifestation of systemic disease. Arch. Intern. Med. (Chicago) 116: 509, 1965. CrossrefMedlineGoogle Scholar69. BARTHOLOMEWCAINWOOLNERUTZFERRIS LGJCLBDCDO: Sclerosing cholangitis: its possible association with Riedel's struma and fibrous retroperitonitis. Report of two cases. New Eng. J. Med. 269: 8, 1963. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: London,From the Royal Free Hospital, London, Eng.This paper was presented as the Lilly Lecture at the 47th Annual Session of the American College of Physicians, April 20, 1966, New York, N. Y.Requests for reprints should be addressed to Sheila Sherlock, M.D., Department of Medicine, The Royal Free Hospital, Gray's Inn Rd., London W. C. 1, Eng. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe Prediction of Hepatotoxiclty Due to Therapeutic Agents in ManHepatic Toxicity of Estrogen in Armenian and Chinese HamstersEstrogen-induced hepatic toxicity and hepatic cancer: differences between two closely related hamster speciesLiver bilirubin UDP-glucuronosyltransferase activity in chronic nonhemolytic unconjugated hyperbilirubinemia of adultsTreatment of acute cholecystitisDiethylstilbestrol-Induced Jaundice in the Chinese and Armenian HamsterChronic intrahepatic cholestasis of sarcoidosisInheritance of the Dubin-Johnson-Sprinz SyndromeBile acid metabolism in infants and children.Benign familial recurrent intrahepatic cholestasisSerum bile acids in primary biliary cirrhosisThe effect of an oral contraceptive on serum lipidsBenign Recurrent Intrahepatic CholestasisAcute nephrotic syndrome as a manifestation of active Hodgkin's diseaseSerum alkaline phosphatase at the onset of Hodgkin's diseasePreoperative Preparation of the Jaundiced Patient: A Review of Current PracticePathophysiology of cholestasisAssessment of Liver Function in Man with Special Reference to HepatotoxicityIntrahepatic Cholestasis Due to AzathioprinePrimary biliary cirrhosisThe Differential Diagnosis of JaundiceOvulatory suppressants, estrogens, and carbohydrate metabolismBILIRUBIN METABOLISM AND JAUNDICE WITH SPECIAL REFERENCE TO UNCONJUGATED HYPERBILIRUBINAEMIAInterference with Bile Pigment Uptake in the Liver by Flavaspidic AcidSevere Postoperative Hyperbilirubinemia Simulating Obstructive JaundiceGenetic Aspects of Liver Disease Associated with Jaundice 1 September 1966Volume 65, Issue 3Page: 397-408KeywordsBiliary systemCholelithiasisCirrhosisExerciseGeneticsHepatitisHepatitis A virusHepatitis E virusLiverPancreas Issue Published: 1 September 1966 CopyrightCopyright ©, 1966, by The American College of PhysiciansPDF DownloadLoading ...