Jaundice

Assalam 3laykum ,
An otherwise healthy 3-week-old boy is brought to the physician's office because of jaundice and
dark urine for the past 2 weeks. He has hepatomegaly, and his stools are loose, claycolored, and acholic. Serum conjugated bilirubin concentration is increased. Which of the following is the most likely cause of the hyperbilirubinemia?

(A) Defect in cholesterol synthesis
(B) Deficiency of glucuronosyltransferase
(C) Hemolysis
(D) Inflammation of the terminal ileum
(E) Obstruction of the biliary system

answer is E. obstruction of the biliary system

I could investigate this patient by : U/S to check for the biliary obstruction, we could use cholangiography and.....
plz feed me back ahmed

hi doc, about ur answer and for everyone who wants to read about jaundice, there is a beautiful figure in Harrison textbook of internal medicine, but i dont know the page cuz i've lost the CD....

about the answer, i remeber for any patient showing obstructive features on liver function tests...this means that the cause my be an intrahepatic biliary obstruction or extrahepatic biliary obstruction...to differentiate we should do an U/S, if it shows dilated biliary tract it is extrahepatic so we can do cholangiography to see the cause...

if the biliary passeges are normal(not dilated), the cause is mostly intrahepatic...so we should search for the causes as viral hepatitis, drug toxicity, primary sclerosing cholangitis, primary biliary cirrhosis.......