Chronic hepatitis with jaundice (biliary cirrhosis)

Summary

The term “biliary cirrhosis” implies that the toxic agent enters through the biliary ducts. This is true of the obstructive types of cirrhosis which have been briefly described. The toxic and infectious type and the type associated with chronic atrophy present the following features.

The etiology varies greatly. Hepatotoxins, metabolic intoxication, infections of the biliary tract, and gastro-intestinal tracts, and systemic infections are the cause of the condition in a large number of cases, but there is still a considerable number of cases in which the etiology is unknown. Patients who have this syndrome live for a long time and are resistant both to the disease and to the treatment. There often are entirely unexpected recoveries. In many cases the chief disturbance is in the excretory function of the liver; this is indicated by disturbances in the excretion of bromsulphalein and in the serum bilirubin. The pathologic findings, which vary with the stage of the disease at which the observations are made, do not differ significantly from those found in cases in which jaundice is absent. Finally, it is probably just as unwise to attempt an anatomic diagnosis and establish a prognosis on the basis of a single examination in such cases as it is to do so in a case in which there are signs of parenchymatous renal disease.