Cholelithiasis, choledocholithiasis, cholecystitis, and cholangitis

A 46-year-old woman was admitted yesterday with epigastric pain and a serum lipase of 3,400 U/L (<60). Ultrasound showed multiple gallbladder stones and a commo…

Pre-internship · middle twist

A 79-year-old woman presents with four days of intermittent cramping abdominal pain, vomiting and increasing abdominal distension. She has no history of abdomin…

Clinical rotations · common

A 45-year-old woman is admitted with epigastric pain radiating to the back and a serum lipase of 2400 U/L (<60). Ultrasound shows multiple small stones in the g…

Clinical rotations · middle twist

A 68-year-old woman presents with two days of constant right upper quadrant and epigastric pain. Overnight she had two episodes of violent, uncontrollable shaki…

Clinical rotations · common