2nd August 2023

A farmer presents to A&E with a sudden worsening of long-standing right upper quadrant pain.

A farmer presents to A&E with a sudden worsening of long-standing right upper quadrant pain. The pain has been ongoing for a few months but acutely worsened 2 hours ago. He appears jaundiced, tachycardic and in severe pain. An ultrasound scan of the abdomen reveals multiple liver cysts.

What is the most likely cause?

Select the SINGLE most appropriate option from the list below. Select ONE option only.