Abstract

A 28 year-old Hispanic female who was 36 weeks pregnant presented to our hospital complaining of 2 days of intermittent right upper quadrant abdominal pain, nausea, and vomiting. She denied any fever, chills, jaundice, changes in her bowel pattern, or recent travel, and had no significant past medical or surgical history. Physical examination revealed a gravid abdomen with mild right upper quadrant tenderness on palpation. Liver function tests (LFTs) were abnormal on admission with an aspartate amino transferase level (AST) of 76 International Units/Liter (IU/L), alanine amino transferase (ALT) of 61IU/L, alkaline phosphatase (AlkPhos) of 226IU/L, total bilirubin (TB) of 1.9 milligrams/deciliter (mg/dL), and a direct bilirubin (DB) of 0.6mg/dl.

Keywords: Liver flukes; Fasciola hepatica; Biliary obstruction; Endoscopic retrograde cholangiopancreatography; Cholelithiasis; Cholecystectomy