ABSTRACT
Bilirubin is a breakdown product of haem that is produced in the liver, spleen and other tissues. It is initially transported in a water-insoluble unconjugated form, bound to plasma proteins. In the liver, bilirubin is conjugated with glucuronic acid to form water-soluble conjugated bilirubin, which is then excreted in bile. Jaundice is a yellowish discoloration of the skin and sclerae caused by the accumulation of bilirubin in the bloodstream. The three main categories of jaundice are as follows: unconjugated hyperbilirubinaemia; intrinsic liver disease; and extrahepatic cholestasis. Intensive-care input is needed in many cases to provide support to the cardiovascular, respiratory and renal systems pending definitive treatment. Splenomegaly may occur in chronic liver disease with portal hypertension, or in conditions associated with extravascular haemolysis, such as red cell membrane disorders, red cell enzymopathies, and haemoglobinopathies. USS or CT of the abdomen may reveal a variety of structural abnormalities of the liver, biliary tract and pancreas.
