Bilirubin is a yellow pigment produced when old red blood cells are broken down. The liver conjugates bilirubin so it can be excreted in bile; this conjugated form is called direct bilirubin. Elevated direct bilirubin typically indicates problems with how the liver processes or excretes bilirubin — such as bile duct obstruction, hepatitis, or certain inherited disorders.
This test is ordered when total bilirubin is elevated to determine the type of jaundice, work up cholestasis or biliary obstruction, and evaluate newborn jaundice. It is typically interpreted alongside total and indirect bilirubin and other liver function tests. Sample type is serum.
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