Obstructive jaundice is jaundice due to poor bilirubin excretion pathways, which can be caused by infections, stones, parasites, tumors, and other factors. Clinically, there may be jaundice, marked painful itching of the skin, clay-like stools, and the liver may be enlarged. Unlike hepatocellular jaundice, GI symptoms are relatively mild and not proportional to the degree of jaundice. Laboratory tests include mild or moderate elevation of transaminases, marked elevation in obstruction such as ALP and GGT, positive urinary bilirubin, and negative urinary bilirubinogen. Imaging tests (ultrasound, CT, MRI, ERCP) may be specific.