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What are the clinical fatures of of obstructive jaundice ?

Following are the features of obstructive jaundice
Urine colour is yellow or mustard oil-like colour (due to conjugated bilirubin).
Stool is clay coloyred coloured (china-clay) with steatorrhoea (steatorrhoea means frothy bulky soft ,greasy  and offensive .This is due to absence of bile pigment in the stool.
Jaundice is greenish yellow due to due to oxidation of bilirubin to biliverdin
Generalised pruritus with scratch marks and shiny nails are seen in obstructive jaundice because the bile acids irritate the free nerve endings.
Sinus bradycardia occurs as bile salts directly inhibit the sinoatrial node.
Xanthelasma near eye and xanthoma in knees, buttocks may be seen due to hypercholestrolemia.
Deficiency of fat soluble vitamin produce 
  • Petechiae, purpura or ecchymosis are seen due to vitamin K deficiency as lack of bile salts produces malabsorption produces
  • Prolonged obstructive jaundice can produce osteomalacia- bonePain. bone fracture due to vitamin D deficiency this is due to malabsorption or steatorrhea and it is called as hepaticosteodystrophy
Gall bladder may be palapable. If it is palpable it indicate that the site of obstruction is bile dut and it is due to carcinoma head of pancreas and not due to choledocholithiasis according to Courvoisiers law
What are the causes of obstructive jaundice?
Obstructive jaundice can be intrahepatic or extrahepatic
Intrahepatic (medical) causes of jaundice are 
  • Cholestatic viral hepatitis.
  • Chronic active hepatitis.
  • Cirrhosis of liver (specially primary biliary cirrhosis).
  • Lymphoma.
  • Drugs azole. methyl testosterone, anabolic steroids.
  • Secondary carcinoma of liver (jaundice is rarely seen in hepatoma).
Extrahepatic /surgical causes of jaundice
  • Gall stone impaction in CBD.
  • Carcinoma of the head of pancreas.
  • Carcinoma of gall bladder.
  • Stricture of CBD.
  • Enlarged glands at porta hepatis
  • Sclerosing cholangitis from inflammatory bowel disease.
What are the medical causes of extrahepat1c obstruction

  • Sclerosing cholangitis in ulcerative colitis.
  • Obstruction by round worm in CBD.
  • Enlarged Iymph nodes at porta hepatis in lymphoma.