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Case Records of the Massachusetts General Hospital
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Volume 354:1295-1303 March 23, 2006 Number 12
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Case 9-2006 — A 35-Year-Old Woman with Recurrent Right-Upper-Quadrant Pain
Rocío M. Hurtado, M.D., Dushyant V. Sahani, M.D., and Richard L. Kradin, M.D.

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Presentation of Case

Dr. Amanda F. Peppercorn (Infectious Diseases): A 35-year-old woman was admitted to this hospital because of recurrent abdominal pain in the right upper quadrant. One year earlier, abdominal pain developed in the right upper quadrant that was unrelated to food intake, position, or respiration. An evaluation by her primary care physician revealed abnormal results of liver-function tests, and a test for hepatitis C antibody was positive. An abdominal ultrasonographic examination showed biliary dilatation. Endoscopic retrograde cholangiopancreatography (ERCP) showed that the major papilla was normal; there were multiple large stones in the common bile duct, the left hepatic duct, and the . . . [Full Text of this Article]

Differential Diagnosis

Biliary-Stone Disease

Ductal Disease

Extrinsic Compression

Recurrent Pyogenic Cholangitis

            Diagnosis of Recurrent Pyogenic Cholangitis

            Management of Recurrent Pyogenic Cholangitis

Clinical Diagnosis

Dr. Rocío M. Hurtado's Diagnosis

Pathological Discussion

Anatomical Diagnoses


Source Information

From the Infectious Disease Unit (R.M.H.) and the Departments of Radiology (D.V.S.) and Pathology (R.L.K.), Massachusetts General Hospital; and the Departments of Medicine (R.M.H.), Radiology (D.V.S.), and Pathology (R.L.K.), Harvard Medical School.



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