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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 346:271-276 January 24, 2002 Number 4
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Case 3-2002— A 17-Year-Old Boy with Biliary Obstruction
M. Susan Moyer, and Fiona M. Graeme-Cook

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Presentation of Case

A 17-year-old boy was admitted to the hospital because of evidence of biliary obstruction.

Seventeen months before admission, the patient was admitted to another hospital because of bloody diarrhea. The serum aspartate aminotransferase level was 75 U per liter. A test for Clostridium difficile was positive. He had not taken antibiotics before the onset of symptoms. A one-month course of metronidazole was prescribed. The patient was then well until several weeks before admission, when he began to have nearly constant crampy, nonradiating pain in the epigastrium, right upper quadrant, and periumbilical area; the pain was exacerbated by eating and was . . . [Full Text of this Article]

Differential Diagnosis

Intestinal Disease

            Celiac Sprue

            Inflammatory Bowel Disease

Liver Disease

Clinical Diagnosis

Dr. M. Susan Moyer's Diagnosis

Pathological Discussion

Anatomical Diagnoses

Addendum

References




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