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Steven J. Rottman, MD; Erica R. Podolsky, MD; Angela L. Mouhlas, MD; Keren Lerner, MD; Constantinos Pavlides, MD

Arch Surg. 2009;144(9):877.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

A 63-year-old white woman presented with a 48-hour history of colicky epigastric and right upper quadrant pain with radiation to her back, low-grade fever, nausea, and vomiting. The patient's medical history was significant for congestive heart failure, hypertension, asthma, sarcoidosis, and scleroderma. Her social history was significant for residing in Durango, Colorado, where a large uranium plant is located. On physical examination, her abdomen was soft with reproducible right upper quadrant and epigastric tenderness. Laboratory results on admission were as follows: leukocyte count, 11 900 cells/µL (to convert to x10⁹ L, multiply by 0.001); hemoglobin, 15.5 g/dL (to convert to grams per liter, multiply by 10.0); platelets, 26.6 x 10⁴ cells/µL; aspartate aminotransferase, 115 U/L (to convert to microkatal per liter, multiply by 0.0167); alanine aminotransferase, 266 U/L; alkaline phosphatase, 146 U/L; . . . [Full Text of this Article]

What Is the Diagnosis?

Author Affiliations: Department of General Surgery, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, Pennsylvania.

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