Small brown-yellow bile plugs are seen here in canaliculi. The total serum bilirubin is increased and the patient demonstrates jaundice (icterus) by physical examination. The easiest place to see this is on the sclerae of the eyes. With obstruction or liver cell injury, the direct bilirubin is greater than indirect (unconjugated) bilirubin. With excess RBC destruction (as with hemolysis), the indirect bilirubin is greater.

---