ERCP for diagnosis and extraction of choledochal phytobezoar causing right upper quadrant abdominal pain and cholestasis in a patient without prior sphincterotomy or biliary instrumentation

A 72-year-old white man with diabetes mellitus and  gastroesophageal reflux, with no history of liver disease, hepatobiliary instrumentation, sphincterotomy, or abdominal trauma, presented with acute right upper quadrant abdominal pain and diaphoresis that had started 1 hour earlier. Physical examination revealed a soft and nontender abdomen. The initial serum liver function test results were all within normal limits but rose acutely to a serum alkaline phosphatase of 224 U/L, aspartate aminotransferase of 355 U/L, alanine aminotransferase of 531 U/L, and total bilirubin of 2.4 mg/dL after 48 hours.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: At the focal point Source Type: research

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