Symptoms and dangers of jaundice in adults

Jaundice is a disease closely related to the liver. The most susceptible groups are infants and children and adults with poor liver and kidney function. One of the obvious symptoms of jaundice is that the sclera, mucous membranes, skin and other tissues are stained yellow. When jaundice is detected in children, it must be treated. Because this disease is quite dangerous. So what are the symptoms and dangers of jaundice in adults?

Clinical manifestations

1. Basic symptoms

(1) The skin, sclera and other tissues turn yellow. When jaundice deepens, urine, sputum, tears and sweat will also turn yellow, but saliva generally does not change color.

(2) Changes in the color of urine and feces.

(3) Gastrointestinal symptoms, often including abdominal distension, abdominal pain, loss of appetite, nausea, vomiting, diarrhea or constipation.

(4) Manifestations of hypercholesterolemia: the main symptoms include: skin itching, bradycardia, abdominal distension, steatorrhea, night blindness, fatigue, mental depression and headache, etc.

2. Associated symptoms

(1) Jaundice with fever is seen in acute cholangitis, liver abscess, leptospirosis, sepsis, and lobar pneumonia. Viral hepatitis or acute hemolysis may first cause fever and then jaundice.

(2) Jaundice accompanied by severe upper abdominal pain may be seen in biliary stones, liver abscess or biliary ascariasis. Severe pain in the right upper abdomen, chills, high fever and jaundice are a triad that indicates acute suppurative cholangitis. Persistent dull pain or bloating in the right upper abdomen may be seen in viral hepatitis, liver abscess, or primary liver cancer.

(3) Jaundice with hepatomegaly. If the enlargement is mild to moderate, the texture is soft or of medium hardness and the surface is smooth, it is seen in acute biliary infection or biliary obstruction caused by viral hepatitis. Obvious swelling, hard texture, uneven surface and nodules are seen in primary or secondary liver cancer. Liver enlargement is not obvious, but the texture is hard, the edges are irregular, and there are small nodules on the surface, which is seen in cirrhosis.

3. Abdominal signs

(1) Abdominal appearance: Liver space-occupying lesions, splenomegaly, retroperitoneal tumors and pelvic tumors all have local bulges in the corresponding parts. When there is a large amount of ascites, the abdomen will appear frog-shaped with a protruding umbilicus. Abdominal wall hernia and umbilical hernia may also occur. Varicose veins of the abdominal wall are seen in portal hypertension, portal vein or inferior vena cava obstruction.

(2) Liver condition: In acute viral hepatitis or toxic hepatitis, jaundice and hepatomegaly coexist. The liver is soft, and tenderness and percussion pain are more obvious. In acute and subacute liver necrosis, jaundice rapidly deepens, but the liver does not enlarge or may even shrink. In chronic hepatitis and cirrhosis, the liver enlargement is not as obvious as in acute hepatitis, and the texture increases and there may be no tenderness. In cirrhosis, uneven edges and large and small nodules may also be felt. In liver cancer, the liver may be enlarged and lose its normal shape, become hard in texture, and may have large masses or smaller nodules palpable. Tenderness may not be significant, but a smooth liver surface cannot rule out deep cancer or subclinical "small liver cancer." When the liver abscess is close to the surface of the liver, the local skin may have signs of inflammation such as redness, swelling, and tenderness. In cases of giant liver abscess, echinococcosis, polycystic liver, and hepatic cavernous hemangioma, the liver area may have a cystic or fluctuating feeling.

(3) Splenomegaly: Jaundice accompanied by splenomegaly is more common in patients in the decompensated stage of various types of liver cirrhosis, chronic active hepatitis, acute hepatitis, hemolytic jaundice, systemic infectious diseases and infiltrative diseases. When cancer invades the portal vein and splenic vein, it can cause splenomegaly. Rare splenic infarction and splenic abscess can also cause similar splenomegaly and tenderness.

(4) Enlarged gallbladder Jaundice accompanied by enlarged gallbladder is a sign of extrahepatic obstruction and the following should be considered: ① Cancerous jaundice is seen in common bile duct cancer, pancreatic head cancer, ampulla of Vater cancer and rare primary duodenal cancer. The gallbladder is smooth, nontender, and movable, and is called the gallbladder. In case of gallbladder cancer, the gallbladder is hard and often tender. Once primary common bile duct stones cause obstruction, the gallbladder may swell and is usually not tender. In cases of gallstones and chronic cholecystitis, the gallbladder atrophies and cannot be palpated. ③ In chronic obstructive cholecystitis, due to the presence of stones in the cystic duct, the chance of gallbladder enlargement is greater than in acute cholecystitis, and the tenderness is not obvious. ④ In chronic pancreatitis, the proliferation of inflammatory fibrous tissue can compress the common bile duct and cause the gallbladder to swell, but the tenderness is not significant. ⑤ Huge stones at the bottom of the gallbladder, congenital bile duct dilatation or biliary ascariasis can also cause gallbladder enlargement, and the tenderness is often not obvious. The gallbladder often atrophies when there is intrahepatic bile stasis. Whether the gallbladder is enlarged helps in the differential diagnosis of jaundice.

(5) Other conditions include hepatitis, pterygium, hepatic encephalopathy and other neuropsychiatric disorders, sparse axillary hair, testicular atrophy, clubbing, hyperkeratosis, spoon-shaped nails, multiple venous thrombosis and bradycardia. Patients with advanced cancer jaundice may also show signs of cancer metastasis. Liver failure may present with encephalopathy and intracranial hemorrhage. Hemoperitoneum, bile peritonitis, cholecystitis and shock can also be seen in patients with cancerous jaundice.