Cholestatic liver dysfunction in Critically ill patient

Abstract

The liver is a vital organ located in the upper right quadrant of the abdomen, below the diaphragm. It has a wide range of functions as detoxification of various metabolites, protein synthesis, and the production of biochemicals which is necessary for digestion. One of the main functions of the liver is formation of bile. Bile is synthesized in the pericentral hepatocytes of the liver. Bile drains directly into the duodenum via the common bile duct or is temporarily stored in the gallbladder via the cystic duct. Cholestasis is defined as a decrease in bile flow due to impaired secretion by hepatocytes or to obstruction of bile flow through intra or extrahepatic bile ducts . Causes of cholestasis can be hepatocellular as liver cirrhosis, neoplasm, drug toxicity and sepsis or Obstructive causes like stones and malignant obstruction. The last years have seen increasing reports of new ICU-associated diseases like secondary sclerosing cholangitis. The development of a secondary sclerosing cholangitis in critically ill patients (SSC-CIP) was first