Bile is a liquid secreted by the liver that contains cholesterol, bile salts, and waste products such as bilirubin. Bile salts aid in the digestion of fats. Bile passes out of the liver through the bile ducts and is concentrated and stored in the gallbladder until it is released into the small intestine after a meal to help with fat digestion.

When an obstruction occurs in the bile ducts, bile accumulates in the liver, and jaundice (yellow color of the skin) develops due to the accumulation of bilirubin in the blood.

Causes of obstruction include the following:

• Gallstones
• Tumors of the bile ducts or pancreas
• Other tumors that have spread to the biliary system
• Trauma including injury from gallbladder surgery
• Choledochal cysts
• Enlarged nodes in the porta hepatis
• Inflammation of the bile ducts

Risk factors include the following:

• History of any of these conditions:
  • cholelithiasis (gallstones)
  • chronic pancreatitis
  • pancreatic cancer
• Recent biliary surgery
• Recent biliary cancer (such as bile duct cancer)
• Abdominal trauma.

In immunosuppressed patients, obstructions can be caused by infections.