2. 1-urin and stool findings: hemolyticobstructivehepatocellular Urine bilinogenincreasedabsentMay increase or decrease Faeces stercobilinincreaseddecreasedDecreased or normal

3. 2-serum for biochemical liver tests: Indirect hyperbilirubinemia :direct<15% Direct hyperbilirubinemia :direct>15%

5. Findings of Hemolytic anemia * Peripheral blood smear microscopy: o fragments of the red blood cells ("schistocytes") can be present o some red blood cells may appear smaller and rounder than usual (spherocytes) o Reticulocytes are present in elevated numbers. This may be overlooked if a special stain is not used. * The level of unconjugated bilirubin in the blood is elevated * The level of lactate dehydrogenase (LDH) in the blood is elevated * Haptoglobin levels are decreased * If the direct Coombs test is positive, hemolysis is caused by an immune process. * Hemosiderin in the urine indicates chronic intravascular hemolysis.

6. Liver function tests Measurement SignificanceNormal value Albumin decreased in chronic liver disease, not considered to be an especially useful marker of liver synthetic function 3.9 to 5.0 g/dL Alanine transaminase (ALT) rises dramatically in acute liver damage, such as viral hepatitisviral hepatitis 9 to 60 IU/L Aspartate transaminase (AST) raised in acute liver damage, but is also present in red blood cells, and cardiac and skeletal muscle and is therefore not specific to the liver 10 to 40 IU/L Alkaline phosphatase (ALP) ALP levels in plasma will rise with large bile duct obstruction, intrahepatic cholestasis or infiltrative diseases of the liver cholestasis 30 to 120 IU/L Total bilirubin (TBIL) Increased total bilirubin causes jaundicejaundice 0.1–1.2 mg/dL Direct bilirubin If elevated,. Bile duct obstruction by gallstones or cancer should be suspected.Bile duct 0–0.3 mg/dL Gamma glutamyl transpeptidase (GGT) more sensitive marker for cholestatic damage than ALP, may be elevated with even minor, sub-clinical levels of liver dysfunction 0 to 51 IU/L

7. Cholangiography imaging of the bile duct (also known as the biliary tree) by x-rays. There are at least two kinds of cholangiography:bile ductx-rays percutaneous transhepatic cholangiographypercutaneous transhepatic cholangiography (PTC): Examination of liver and bile ducts by x-rays. This is accomplished by the insertion of a thin needle into the liver carrying a contrast medium to help to see blockage in liver and bile ducts.liver endoscopic retrograde choledochographyendoscopic retrograde choledochography (ERC): Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x-rays.stomach duodenum pancreasx-rays

8. Ultrasonography shows dilated common bile duct

9. A bile duct visualization technique of MRI shows dilated bile duct and an obstruction (arrow)