Which conditions are examples of obstructive liver diseases?

• A. Cholangiocarcinoma, choledocholithiasis, common duct stricture, extra-hepatic mass compression
• B. Fatty liver
• C. Hepatitis
• D. Portal vein thrombosis

Answer: (A)

Obstructive liver diseases are conditions that block bile from draining through the biliary ducts, leading to cholestasis. The best example set includes lesions or processes that physically narrow or block the biliary tree outside the liver or at its entrance: cholangiocarcinoma can develop within the bile ducts themselves, choledocholithiasis are stones in the common bile duct, a common duct stricture narrows the duct, and an external mass can compress the biliary system and impede flow. When bile flow is obstructed, you often see a cholestatic pattern on labs and symptoms like jaundice, dark urine, pale stools, and itching due to bile buildup.

Fatty liver and hepatitis involve hepatocellular injury or fat accumulation within liver cells, not blockage of the bile ducts. Portal vein thrombosis affects hepatic blood flow rather than the biliary system, so it doesn’t create obstructive cholestasis.