Cholestasis An alternative or concomitant response to injury caused by extrahepatic or intrahepatic obstruction to bile flow Accumulation in serum of substances normally excreted in bile such as direc-reacting bilirubin choesterol bile acid trace elements occursCholestasis ◼ An alternative or concomitant response to injury caused by extrahepatic or intrahepatic obstruction to bile flow. ◼ Accumulation in serum of substances normally excreted in bile such as ◼ direc-reacting bilirubin ◼ choesterol ◼ bile acid ◼ trace elements occurs