Jaundice

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

  • Onset of symptoms
  • Past history including previous jaundice
  • Alcohol, smoking and illicit drug use
  • Overseas travel

Tests

Initial work up:

  • LFTs
  • Hepatocellular (elevated transaminases):
    • Viral serology: HAV, HBV, HCV, EBV, CMV
  • Abdominal Ultrasound if cholestatic (elevated ALP & GGT)
  • FBE
  • U&Es
  • If isolated raised bilirubin: haemolysis screen
  • Prothrombin time/INR
  • Immunoglobulins
  • Autoantibodies (SMA, AMA)
  • Clinical evidence of encephalopathy
    • Abdominal ultrasound
    • CT where appropriate

Interim/GP management

To refer a patient with this condition, please see the Gastroenterology clinic page for the full referral process and templates.

For more information please see the Tasmanian Health Pathways website.

Emergency

Urgent / category 1

When patient presents with any of the following, contact Gastroenterology Registrar via switch 6166 8308:

Refer to Emergency Department OR Liver Clinic (depending on severity)

Semi-urgent / category 2

Unexplained non-obstructive cholestatic jaundice

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6426 5115
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6430 6691
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6222 8919

Urgent:

We will endeavour to see these patients within four weeks

Urgent referrals should be accompanied by a phone call to the clinic and the relevant doctor for urgent assessment, or patient should be directed immediately to the Emergency Department.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment