30th September 2020

A 34-year-old gentleman presented to the Emergency Department with severe right upper quadrant pain

A 34-year-old gentleman presented to the Emergency Department with severe right upper quadrant pain. He stated that the pain started about 3 days ago and is worsening but not radiating. On examination, he is found to have a temperature of 38.4°C, scleral icterus and right upper quadrant tenderness. He is a patient with long-standing Ulcerative Colitis which is currently well controlled and also previously known hospital admissions for recurrent bacterial cholangitis. 

Which of the following options would be appropriate as part of your management plan?