**3.6 Obstructive jaundice**

The common causes of obstructive jaundice are biliary atresia in children and gall stones or malignancy in adults. Sepsis is the most dreaded complication of obstructive jaundice before or after surgical intervention. The sepsis in obstructive jaundice is preceded by dysbiosis, increased epithelial permeability and translocation of bacteria [74, 75]. A state of relative immunosuppression that generally exists in the gut is lost, and a pro-inflammatory state ensues as evidenced by increased baseline interleukin-6 and C-reactive protein [76, 77].
