Bile and Jaundice: A Visual Guide for Medical Students

Why is the urine dark but the stool pale? Why does the INR rise in obstructive jaundice, and why does it usually correct with vitamin K? Answer both and you understand bile.

This guide follows bile acids around their circuit, then uses that circuit to work through the patient with jaundice. Every page is built the same way: one clear diagram, the key points, what it means at the bedside, a surgical pearl, and a quick self-check question.

DOI: 10.5281/zenodo.23006422 · Licensed CC BY-NC 4.0 · Deposited in Zenodo and indexed by OpenAIRE

Part 1 · The circuit, in ten steps

1. Hepatic synthesis and the canalicular pumps
2. Storage and concentration in the gallbladder
3. Release after a meal: the CCK reflex
4. Emulsification, micelles and fat absorption
5. Reabsorption in the terminal ileum
6. Return to the liver
7. Colonic bacteria and secondary bile acids
8. Loss and regulation: FXR and FGF19
9. Bile acids as hormones, and metabolic surgery
10. The whole circuit, and what happens when it breaks

Part 2 · The patient with jaundice

11. Bilirubin metabolism: the bridge from Part 1
12. Classifying jaundice: where is the block?
13. Taking the history (two pages)
14. Examining the jaundiced patient (two pages)
15. Interpreting the blood and urine tests (three pages)
16. Imaging and first management pathway
17. Four patients, ten questions, a one-page summary