Case presentation A 30-year-old woman was admitted to the hospital with sharp and sluggish pain in her lower right quadrant for the last two days. Nausea, vomiting, diarrhea, constipation, or fever were absent. Medical history The medical and surgical records confirmed hypothyroidism, penicillin hypersensitivity reaction, and a laparoscopic cholecystectomy performed ten years ago. Social history: The patient denied the intake of alcohol, smoking, or drugs.
Physical examination: Physical examination revealed regular bowel sounds, healthy peritoneal signs, and guarding. Laboratory examination Moderate leukocytosis with a slight increase in the neutrophil levels Abdominal and pelvic CT revealed moderate intra-and extrahepatic biliary bile dilatation. Abdomen MRI did not demonstrate choledocholithiasis. The preliminary examination ruled out acute appendicitis, ectopic pregnancy, and…
