Cholestatic hepatotoxicity

Cholestasis
Micrograph showing bile (yellow) stasis, i.e. cholestasis. H&E stain.
Classification and external resources
Specialty	Gastroenterology
ICD-10	K71.0, K83.1
ICD-9-CM	576.2
DiseasesDB	9121
MedlinePlus	000215
eMedicine	ped/383
Patient UK	Cholestasis
MeSH	D002779
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Cholestasis is a condition where bile cannot flow from the liver to the duodenum. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system that can occur from a gallstone or malignancy, and metabolic types of cholestasis which are disturbances in bile formation that can occur because of genetic defects or acquired as a side effect of many medications.

Possible causes:

Drugs such as gold salts, nitrofurantoin, anabolic steroids, chlorpromazine, prochlorperazine, sulindac, cimetidine, erythromycin, estrogen, and statins can cause cholestasis and may result in damage to the liver.

Bile is secreted by the liver to aid in the digestion of fats. Bile formation begins in bile canaliculi that form between two adjacent surfaces of liver cells () similar to the terminal branches of a tree. The canaliculi join each other to form larger and larger structures, sometimes referred to as the Canals of Hering, which themselves join to form small bile ductules that have an epithelial surface. The ductules join to form bile ducts that eventually form either the right main hepatic duct that drains the right lobe of the liver, or the left main hepatic duct draining the left lobe of the liver. The two ducts join to form the common hepatic duct, which in turn joins the cystic duct from the gall bladder, to give the common bile duct. This duct then enters the duodenum at the ampulla of Vater.

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Wikipedia