Hyperbilirubinemia occurs in pancreatitis because

• A. Pancreatic edema obstructs the bile duct
• B. Liver failure
• C. Hemolysis
• D. Gallstone obstruction of the bile duct

Answer: (A)

Inflammation of the pancreas can cause swelling that blocks bile flow. When the pancreas, especially its head region, becomes edematous, it can press on the common bile duct and impede the drainage of bile into the intestine. This obstruction causes bile to back up into the liver and spill into the blood as conjugated bilirubin, producing hyperbilirubinemia consistent with obstructive jaundice.

This mechanism is distinct from liver failure, which would reflect hepatocellular injury and a different bilirubin pattern, and from hemolysis, which raises unconjugated bilirubin due to increased red cell breakdown. Gallstone obstruction can also cause obstructive bilirubin elevation, but in the context of pancreatitis, the typical explanation is edema-induced compression of the bile duct.