A 26-year-old woman presented with right upper quadrant abdominal pain of 18 months' duration that began after an episode of self-limited viral gastroenteritis. According to her, it was a “sharp" and “burning” discomfort that is well localized and continuous. Her review of systems is otherwise unremarkable, and she was previously healthy apart from mild depression that was being effectively treated with fluoxetine.
The patient was taking no other medications. Abdominal ultrasonography demonstrated sludge in the gallbladder with a normal liver and ordinary findings on esophagogastroduodenoscopy. Examination findings Body mass index: 30 kg/m 2 Right upper quadrant of the abdomen: Moderate focal tenderness Laboratory results Alanine Aminotransferase: 50 U/L Aspartate Aminotransferase: 30 U/L Chemistry group and complete blood count: Unremarkable
