A 60-year-old man presented to the emergency department with melena, generalized abdominal pain, discoloration of the sclera, lethargy, shortness of breath, and mild chest pain for five days. History The patient had a history of recurring glioblastoma treated with tumor excision and chemotherapy. Investigations A physical examination revealed the following – Paleness Severe icterus Tachypnea Pulse – 120 beats/min Oxygen saturation – 98% Blood pressure – 110/70 Tenderness in the right hypochondrium without any organomegaly or palpable masses A digital rectal examination showed melena. Laboratory findings An electrocardiogram revealed sinus tachycardia.
While the X-ray was normal, an ultrasound of the abdomen showed a cystic structure with bi-directional color flow located near the pancreatic head. The intrahepatic ducts and the common bile ducts were dilated. Both the kidneys…
