Case 15-1981

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Abstract
Presentation of CaseA 69-year-old woman was admitted to the hospital because of pain in the right upper quadrant.A cholecystectomy had been performed 30 years earlier. She was well until eight months before admission, when she experienced right-upper-quadrant pain that radiated to the right shoulder. Physical examination revealed only local tenderness. The urea nitrogen was 17 mg per 100 ml (6.1 mmol per liter), the glucose 107 mg per 100 ml (5.9 mmol per liter), the bilirubin 0.4 mg per 100 ml (6.8 μmol per liter), and the protein 7.9 g (the albumin 3.6 g, and the globulin 4.3 . . .