Cholestasis is bile formation and/or bile flow impairment that manifests as fatigue, pruritus and jaundice.
It can be classified into intrahepatic or extrahepatic cholestasis.
Extrahepatic cholestasis develops from mechanical blockage in the duct system or hepatocellular defects.
Intrahepatic cholestasis may be due to functional defects hepatocellularly or from obstructive lesions of the intrahepatic biliary tract distal from the bile canaliculi.


  • Any condition that causes bile formation and/or bile flow impairment that may lead to:
    • Retention of conjugated bilirubin and its regurgitation into serum
    • Increased serum concentration of unconjugated bilirubin
    • Increased bile salts


Extrahepatic Cholestasis

  • Cholestasis that develops from mechanical blockage in the duct system or hepatocellular defects
  • It may be caused by stones, tumors, cysts, or strictures
  • This class will not be discussed here

Intrahepatic Cholestasis (IHC)

  • Hepatocellular functional defects or presence of obstructive lesions in the intrahepatic biliary tract distal from bile canaliculi resulting to cholestasis
  • Chronic (lasts >6 months) cholestatic diseases are commonly intrahepatic

Signs and Symptoms

  • Fatigue
  • Pruritus
  • Jaundice
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