26th April 2024

A 47-year-old woman presents with a 2-day history of intense and steady pain in the right upper quadrant of the abdomen.

A 47-year-old woman presents with a 2-day history of intense and steady pain in the right upper quadrant of the abdomen. The pain occasionally radiates to her right shoulder and intensifies after eating meals. She reports nausea but no vomiting. She has a low-grade fever of 37.5°C. Her medical history is significant for obesity and multiple pregnancies.

On examination, she exhibits tenderness in the right upper quadrant. She is not jaundiced, and her abdomen is soft with no palpable masses.

Investigations:

Complete blood count: Elevated white blood cell count with neutrophilia

Liver function tests: Mildly elevated bilirubin and alkaline phosphatase

Which is the most likely diagnosis?