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Updated: Aug 4, 2026
06:45
Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
Published on: December 18, 2010
[Sepsis associated cholestasis in adults]
R Levinson1, M Horowitz, M J Rapaport
1Dept. of Internal Medicine C, Assaf Harofeh Zerrifin, Israel.
Harefuah
|June 26, 2001
Summary
Sepsis can cause early liver injury, known as cholestasis, which presents with elevated direct bilirubin before sepsis symptoms appear. Understanding this early hepatic complication is crucial for timely diagnosis and avoiding unnecessary procedures.
Area of Science:
- Hepatology
- Microbiology
- Immunology
Context:
- Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
- Hepatic injury is a recognized complication of sepsis, often presenting late with jaundice and elevated transaminases.
- Early cholestatic liver injury preceding sepsis is less understood but characterized by elevated direct bilirubin.
Purpose:
- To review the pathophysiological basis of sepsis-associated cholestasis.
- To elucidate the clinical presentation and prognostic implications of early cholestatic liver injury in sepsis.
- To highlight the importance of recognizing sepsis-associated cholestasis for improved patient outcomes.
Summary:
- Sepsis-associated cholestasis involves gram-negative bacterial endotoxins and cytokines interfering with bile acid transporters.
- This early liver injury is marked by increased direct bilirubin with minimal elevation in liver enzymes.
- Experimental models support the role of endotoxins and cytokines in sepsis-induced cholestasis.
Impact:
- Improved recognition of early cholestatic liver injury can prevent unnecessary diagnostic procedures.
- Timely diagnosis of sepsis-associated cholestasis can lead to prompt and appropriate treatment.
- Understanding the mechanisms of sepsis-associated cholestasis may inform future therapeutic strategies.
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