Patient History: A GP has referred a 64-year-old woman to the general surgical team on call. She has been complaining of pain in the upper part of the abdomen and generalized itching. Her daughter has also noticed a yellowish discoloration of her skin. The symptoms began about a week ago and became gradually worse. On further questioning, she reports passing dark urine and pale stools for the last few days. She is usually fit and well, does not drink alcohol and denies any recent foreign travel.
Physical Examination: The patient is clinically jaundiced and tender in the right upper abdomen. The liver is not enlarged and rectal examination reveals pale stool on the glove. Her temperature is 37°C, blood pressure 130/80 mmHg and pulse rate 72/min. Bilirubin is detected on urinalysis. Laboratory Findings: What would be your approach to managing this patient? *This patient case is from…
