Physiology of biliary obstruction

Q) Infection in obstructive jaundice all are true except

a) There is loosening of hepatic tight junctions and cholangiovenous reflux

b) IgM production from liver cells decreased

c) Reduced bacteriostatic & bactericidal action due to decreased bile salts in bowel

Answer 

In  patients  with  long-standing  obstruction,  intrahepatic bile ductule  proliferation occurs with an increase in the length and tortuosity of the canaliculi. The  biliary  system  normally  has  a  low  pressure  (5  to  10  cm H2O);  however,  in  the  setting  of  complete  or  partial  biliary obstruction,  biliary  pressure  can  approach  30  cm  H2O. 

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