Abstract
The concept of cholestasis refers to difficulty or stoppage of bile flow. It is a common clinical problem that can be the manifestation of multiple diseases. A distinction can be drawn between intrahepatic cholestasis, when there is abnormality in the liver parenchyma, and extrahepatic cholestasis, if the obstruction is located in the common bile duct. A detailed case history and physical examination are essential in order to guide the diagnosis. An abdominal ultrasound is the first imaging test to be performed. In the presence of a normal or inconclusive ultrasound, the study should be expanded with other more specific imaging tests. If malignancy is suspected, an abdominal computed tomography scan should be the first diagnostic procedure. An oral endoscopic ultrasound and magnetic resonance cholangiopancreatography are examinations with a high diagnostic yield that is comparable between them. Endoscopic retrograde cholangiopancreatography allows for direct visualization of the bile duct with the possibility of performing treatment.
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