Snapshot A 56-year-old woman presents to the emergency room for skin discoloration, fevers, and abdominal pain. Her past medical history includes hyperlipidemia, obesity, diabetes, and gallstones. On physical exam, she is febrile, tachycardic, and jaundiced. She is tender to palpation in the right upper quadrant. She is alert and oriented with a normal mental status. Laboratory reveals markedly elevated alkaline phosphatase and white blood cell count. A right upper quadrant ultrasound shows intrahepatic biliary dilatation. She is started on broad-spectrum antibiotics and scheduled for an endoscopic retrograde cholangiopancreatography (ERCP). Introduction Clinical definition login to view 1 more bullet Epidemiology Demographics login to view 1 more bullet Risk factors login to view 4 more bullets ETIOLOGY Pathogenesis login to view 2 more bullets Presentation Symptoms login to view 8 more bullets imaging Right upper quadrant ultrasound login to view 4 more bullets Magnetic resonance cholangiopancreatography (MRCP) login to view 4 more bullets Studies Diagnostic testing login to view 5 more bullets DIAGNOSIS login to view 10 more bullets Differential Acute cholecystitis login to view 3 more bullets Treatment Management approach login to view 1 more bullet First-line login to view 8 more bullets Second-line login to view 4 more bullets Complications Hepatic abscesses Portal vein thrombosis