The authors, after an extensive review of the differential diagnostic criteria of the different types of intra- and extrahepatic cholestasis, present the results of a morphological study performed on the basis of 34 cases of cholestatic syndrome, 19 due to extrahepatic obstruction and 15 to an intrahepatic genesis. In all the cases, the day of the jaundice was exactly stated. The statistical analysis of the semi-quantitative evaluation of 31 histological elementary lesions allowed to the following conclusions. The criteria for a more confident diagnosis of extrahepatic cholestasis are represented by: peripheral portal oedema; rounding of the portal spaces; periductal laminar oedema; acute cholangiolitis of the newformed and of the preexisting ductules; ectasia of the interlobular ducts; and periportal ductual proliferation. It is possible to date an extrahepatic cholestasis with sufficient accuracy. In the first phases the portal oedema, together with neoductular peripheral proliferation, mild cholangiolitis and centrilobular cholestasis, predominates. Between the 20th and 30th day, the ectasia of the interlobular ducts develops. The period between the 31st and the 40th day of cholestasis is characterized by the amount of the ductular proliferation and by the presence of bile pigments in the portal tracts and of bile thrombi in the ducts. After the 41st day, the biliary infarcts appear and all the previous elementary lesions reach the highest degree.
|Translated title of the contribution||The differential diagnosis of cholestasis|
|Number of pages||24|
|Publication status||Published - 1980|
ASJC Scopus subject areas
- Pathology and Forensic Medicine