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A 67-year-old Caucasian man presented to our department with a 10-day history of painless jaundice and generalised pruritus. He reported no alcohol or drug intake, no history of travelling abroad and no significant personal or family medical history. Physical examination was normal except for excoriations.
Laboratory studies revealed cholestasis with markedly increased conjugated bilirubin (466.9 µmol/L) and an alkaline phosphatase (AP) level of 445 IU/mL. Transaminase, gamma-glutamyl transferase (GGT), serum albumin and prothrombin levels were within normal range. The extended viral hepatitis panel was negative as were the antimitochondrial and antinuclear antibodies. Abdominal ultrasound showed gallbladder stones and a 7 mm diameter common bile duct with no visible obstruction or intrahepatic biliary dilatations. The …
Contributors AMV and AC wrote and submitted the paper. TAV reviewed the manuscript and references and corrected the text.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.