31st July 2023

A 56-year-old man presents to A&E with acute RUQ pain. He has no known history of gallstones

A 56-year-old man presents to A&E with acute RUQ pain. He has no known history of gallstones, but has had an episode like this once before. His observations show a temperature of 39.5oC and sinus tachycardia. Examination reveals an underweight, unwell patient with scleral icterus. His abdomen is soft but tender, worst in the RUQ. Bloods show deranged liver function (specifically ALP and bilirubin), a CRP of 137 and neutrophilia. Peripheral blood cultures are taken.

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