choluria

Clinically, hemobilia can present as hematemesis, melena, or hematochezia, with or without choluria, depending on the rate of bleeding and anatomical factors (e.g., postbilioenteric surgical anatomy).

Additionally, yellowish pigmentation was observed in the gravel of boxes (choluria), and stools were clearly pale (acholia) (Figure 2).

Acholia ("without bile" or pale stools) and choluria ("dark urine") occur in posthepatic jaundice because of an obstruction of bile secretions into the small bowel and increased secretion of bilirubin into the urine.

Choluria, the product of increased conjugated bilirubin (DB) has been described in malaria patients developing liver dysfunction as well as in kidney dysfunction by the toxic action of bilirubin on renal epithelium [7, 19, 20].