Many labs cannot measure 5 nucleosidase and ALP levels so, GGT may be measured in some cases. Abnormal GGT elevation may be attributable to a variety of factors. As such, GGT elevations lack the necessary specificity to be a useful confirmatory test for cholestasis.Importantly, conjugated hyperbilirubinemia is present in 80% of patients with extrahepatic cholestasis and 50% of patients with intrahepatic cholestasis. Given that many patients with hyperbilirubinemia may not have cholestasis, the measurement of bilirubin levels is not a good diagnostic tool for identifying cholestasis. In a later stage of cholestasis aspartate transaminase (AST), alanine transaminase (ALT) and unconjugated bilirubin may be elevated due to hepatocyte damage as a secondary effect of cholestasis. Imaging
After determination using biomarkers, a variety of imaging studies may be used to differentiate between intrahepatic or extrahepatic cholestasis. Ultrasound is often used to identify the location of the obstruction but, is often insufficient in determining the level of biliary obstruction or its cause because it can pick up bowel gas that may interfere with readings. CT scans are not impacted by bowel gas and may also be more suitable for overweight patients. Typically, the cause of cholestasis and magnitude of obstruction is better diagnosed with CT compared to ultrasound. MRI scans provide similar information to CT scans but are more prone to interference from breathing or other bodily functions.Although CT, ultrasound, and MRI may help differentiate intrahepatic and extrahepatic cholestasis, the cause and extent of obstruction is best determined by cholangiography.
Extravasation of urine refers to the condition where an interruption of the urethra leads to a collection of urine in other cavities, such as the scrotum or the penis in males. It can be associated with a calculus. Mechanism
An injury to the urethra leaving Bucks fascia intact results in a collection of urine (extravasation) limited to the penis, deep to Bucks fascia. However, if the injury to the bulb of the penis results in urethral injury accompanying a tear of the Bucks fascia, then extravasated blood and urine would accumulate in the superficial perineal space, passing into the penis (outer to Bucks fascia) as well as the scrotum and lower anterior abdominal wall. Extravasation of urine involving a compromised Bucks fascia can be appreciated clinically by blood collecting in the superficial pouch, resulting in a butterfly-shaped region around the penis. Urinoma
Long term complications of renal trauma, ureteral obstruction, or kidney transplant can lead to the formation of an urinoma encapsulating extravasated urine. References


== External links ==