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A 54-year-old man underwent autologous peripheral stem-cell transplantation for acute myelogenous leukemia in second remission. Fifteen days later, right-upper-quadrant pain and jaundice occurred with the resumption of oral feeding after a prolonged period of total parenteral nutrition. The bilirubin level rose from 0.9 to 5.5 mg per deciliter (15.4 to 94.0 µmol per liter), and the alkaline phosphatase level from 95 to 386 U per liter, while the aminotransferase and amylase levels remained normal. Ultrasonography revealed a distended gallbladder that was 16 cm long (arrowheads in Panel A) and 6 cm wide (arrowheads in Panel B) and was filled with . . . [Full Text of this Article] |
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