Oriental cholangiohepatitis

Published:April 15, 2022DOI:
      A 73-year-old man presented to the emergency department with a 3-day history of right upper quadrant pain. His medical history was significant for chronic obstructive pulmonary disease. He was febrile at 38.3°C, tachycardic at 120 beats per minute, hypotensive at 95/50 mm Hg, and tachypnoeic at 26 breaths per minute. On examination, he was confused and jaundiced. On palpation, there was right upper quadrant tenderness without evidence of peritonism. He had an elevated white cell count of 16 × 109/L, a cholestatic pattern of liver function test derangement with an elevated bilirubin of 31 μmol/L, and an elevated alkaline phosphatase of 160 U/L.
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