Icterisch met een zwart randje

Background

Jaundice is a clinical symptom as a result of cholestasis. It can be caused by a wide variety of disorders. Its differential diagnosis is broad. Therefore, it is important to determine whether the cause of the cholestasis is intrahepatic, hepatic or extrahepatic.

Case description

This article describes a 61-year-old male who was referred to our Gastroenterology Department. Transabdominal ultrasound showed dilatation of intrahepatic bile ducts and the common bile duct, probably caused by a sludge ball. He underwent an ERCP during which a mass instead of a gallstone was extracted. Histological examination showed (a metastasis of) a melanoma. The patient was referred to the dermatologist who found a melanoma on the chest. The final diagnosis was metastasis of melanoma to the common bile duct.

Conclusion

Jaundice can be caused by a variety of disorders. A systematic approach based on signs and symptoms is essential to recognize uncommon diagnoses without unnecessary delay.

Conflict of interest and financial support: none declared.