22nd April 2024

A 30-year-old male presents to his GP with painless jaundice

A 30-year-old male presents to his GP with painless jaundice. He has noticed his eyes taking a yellow tinge, and his skin has been a little itchy over the last few days. He has recently completed a prolonged course of co-amoxiclav following treatment for an empyema on the respiratory ward. His weight has been stable and aside from the itch, he has been feeling well in himself.

He reports binge drinking with friends every few weeks. He smokes 5 cigarettes a day. He does not take any over the counter medication. On examination, his abdomen is soft and non-tender. There is no discernible ascites. He is slightly jaundiced.

Investigations show the following:

You note an abdominal ultrasound scan from his recent hospital admission, which showed the following:

“The gallbladder is thin walled with no gallstones present. The common bile duct is of normal diameter. The liver has normal texture and echogenicity with a smooth outline”.

What is the most likely cause of his presentation?

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