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Finding-the-Path: Case 9

History

Two weeks after a laparoscopic cholecystectomy, a 24-year-old woman presents to the emergency room with right upper quadrant (RUQ) pain and fever. On physical examination, she has a temperature of 39 degrees Celsius, marked RUQ tenderness and mild peritoneal signs. Her white blood cell count (WBC) is 14.5 K/ml. Supine and upright plain radiographs of the abdomen reveal mild ileus but no bowel obstruction.

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