Case of a Man with Yellow Discoloration of the Skin and Sclera and Abdominal Pain

Case presentation An 88-year-old man presented with possible appendicitis. He was unable to give an accurate history. He had high abdominal pain on his right side.

Physical examination A yellow discoloration of the skin and sclera was observed, and abdominal examination revealed that the maximal tenderness was in the right upper quadrant. Laboratory findings   Hemoglobin: 15.6 g/dL   (Normal range: 11.5–16.0 g/dL) Mean cell volume: 86 fL (Normal range:76–96 fL) White cell count: 22 x 10 9 /L (Normal range: 4.0–11.0 x 10 9 /L) Sodium: 137 mmol/L (Nomal range: 135–145 mmol/L) Potassium: 4.7 mmol/L (Normal range: 3.5–5.0 mmol/L) Urea: 6.2 mmol/L (Normal range: 2.5–6.7 mmmol/L) Creatinine: 71 μmol/L (Normal range: 44–80 μmol/L) Amylase: 68 IU/dL (Normal range: 0–100 IU/dL) Aspartate transaminase (AST): 69 IU/L (Normal range: 5–35 IU/L) Alkaline phosphatase (ALP): 441 IU/L (Normal range:…