A 26-year-old woman presented to her family physician with a complaint of abdominal pain in the right upper quadrant of the stomach. The abdominal pain of the patient persisted for 18 months after an acute attack of viral gastroenteritis. She described the pain as sharp, burning, localized and continuous which slightly worsened after meals and aggravated after a bowel movement.
She reported having mild depression which was being treated with fluoxetine. Rest of her systemic examination was unremarkable. Physical examination Body mass index (BMI): 30 kg/m 2 Gastrointestinal examination: Moderate focal tenderness in the right upper quadrant of the abdomen Laboratory examination CBC: Normal Electrolytes: Normal Alanine transaminase (ALT): 50 U/L Aspartate Aminotransferase (AST): 30 U/L Diagnostic test Abdominal sonography: Sludge in the gallbladder with a normal liver…
