Gastrointestinal System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This elderly woman has presented with fever, right upper abdominal pain, and jaundice, i.e., Charcot\u0027s triad. This should be considered to be acute cholangitis until proven otherwise. The other diagnoses to consider are acute cholecystitis or a hepatic abscess. However, the absence of Murphy\u0027s sign is a point against the former; and the lack of hepatomegaly, a point against the latter.\n\nHer evaluation should continue with a full blood count, liver profile, and ultrasound of the abdomen. The full blood count shows a neutrophil leukocytosis, indicating systemic inflammation. The liver profile reveals direct hyperbilirubinemia and mild transaminase elevation, indicating cholestasis. The ultrasound scan shows the common bile duct to be dilated,"}]}

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