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What is Absent urobilinogen in urine with icterus indicates? and explain in detail?
Ans. (a) Perihepatic obstruction(Ref: Robbins 9th/830-840; Harrisons 18th/chapter 42)ConditionSerum BilirubinUrine UrobilinogenUrine BilirubinFecal UrobilinogenNormalDirect 0.1-0.4 mg/dlIndirect 0.2-0.7 mg/dl0.4 mg/24 hAbsent40-280 mg/24hHemolytic anemia|IndirectIncreasedAbsentIncreasedHepatitis|Direct and indirectDecreased if micro obstruction is presentPresent if micro obstruction occursDecreasedObstructive jaundice| DirectAbsentPresentTrace to absent