[Icterus - in intensive care]

Jaundice is often the first and also most prominent sign of liver disease. A knowledge of liver involvement in systemic and extrahepatic disease is of practical significance for a precise diagnosis and specific therapy. Since this syndrome is complex with multifactorial causes, the following classification has been employed. Jaundice in heart failure, drug-induced jaundice, jaundice resulting from infection, postoperative jaundice. In the discussion the following points have been emphasized. A pattern of jaundice similar to hepatitis can be observed even in isolated left heart failure. Tetracyclines are able to cause an acute fatty liver with jaundice. Clostridia infections should always be considered in the case of raised indirect bilirubin postoperatively. Cautious waiting is indicated initially in the case of "benign postoperative cholestasis".