Snapshot A 46-year-old obese woman presents to her gastrointestinal doctor for colicky right upper quadrant pain and pruritus. She denies having any weight loss, fevers, or chills. She does report having pruritus worse at night, as well as fatigue and light-colored stool. Labs show elevated alkaline phosphatase. A right upper quadrant ultrasound shows intrahepatic dilation of bile ducts and stones in the gallbladder. She is scheduled for a consultation with general surgery and started on ursodeoxycholic acid and cholestyramine. Introduction Overview login to view 1 more bullet Epidemiology Risk factors login to view 7 more bullets ETIOLOGY Pathogenesis login to view 2 more bullets Presentation Symptoms login to view 7 more bullets Physical exam login to view 4 more bullets Imaging Ultrasound login to view 7 more bullets Studies Serum labs login to view 4 more bullets Differential Primary biliary cholangitis login to view 2 more bullets Hemochromatosis login to view 2 more bullets Wilson disease login to view 3 more bullets Treatment Management approach login to view 2 more bullets Medical login to view 6 more bullets Complications Ascending cholangitis