Which condition results in retained conjugated bilirubin?

The condition that results in retained conjugated bilirubin is cholestasis. Cholestasis refers to a decrease in bile flow due to a blockage or dysfunction of the bile ducts, either intrahepatic or extrahepatic. This impairment prevents bilirubin from being excreted into the intestine, causing an accumulation in the bloodstream. Since conjugated bilirubin is water-soluble and is formed in the liver, its retention indicates that the liver is processing bilirubin properly, but the transport and excretion pathways are compromised.

In contrast, Gilbert's syndrome is a benign condition characterized by the unconjugated hyperbilirubinemia due to reduced activity of the enzyme that conjugates bilirubin, leading to elevated unconjugated rather than conjugated bilirubin. Hemolytic anemia involves the breakdown of red blood cells, resulting in excess production of bilirubin, primarily unconjugated. Hepatitis can cause elevated bilirubin levels but may lead to both conjugated and unconjugated bilirubin elevations depending on the severity and type of liver dysfunction. However, cholestasis is specifically tied to the retention of conjugated bilirubin due to bile flow obstruction.