| Parameter | Biliary obstruction | Liver disease |
| History | Abdominal pain
Fever, rigors Prior biliary surgery Older age |
Anorexia, malaise, myalgias (viral prodrome)
Known viral exposure History of blood product receipt or injection drug use Exposure to known hepatotoxin Family history of liver disease |
| Physical examination | Fever
Abdominal tenderness Palpable abdominal mass Abdominal surgical scar |
Spider telangiectasias
Stigmata of portal hypertension(e.g., prominent abdominal veins, splenomegaly, ascites) Asterixis |
| Laboratory studies | Predominant elevation of serum alkaline phosphatase relative to aminotransferases
Prothrombin time (INR) normal or normalizes with Vitamin K administration Leukocytosis Elevated serum amylase or lipase level |
Predominant elevation of serum aminotransferase levels relative to alkaline phosphatase
Prolonged prothrombin time that does not normalizes with Vitamin K administration Thrombocytopenia Serologies indicative of specific liver disease |
Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th Ed. Elsevier Saunders, 2016