Abstract
We experienced 2 cases of significant conjugated hyperbilirubinemia after multiple trauma. Usually, the resorption of massive hematoma and large quantities of transfusions increase the production of unconjugated bilirubin. Conjugated hyperbilirubinemia was mainly caused by 2 factors consisted of an impaired active transport of conjugated bilirubin to intrahepatic duct following hepatic hypoperfusion under the shock, and hyperproduction of bilirubin due to the resorption of massive hematoma. According to the clinical course of the improvement of hyperbilirubinemia, other factors including resorption by fasting, mechanical ventilation with PEEP, decreased intestinal motility and bile excretory impairment caused by the shock, the high dose of catecholamine and the narcotics might be associated with the hyperbilirubinemia. Further study about the effect on the hyperbilirubinemia by sivelestat sodium might be necessary. And, the treatment which took up the conjugated hyperbilirubinemia itself is not necessary.
