Abstract

Question: A 28-year-old Latin American woman who emigrated from southern Mexico 1 year ago developed recurrent biliary colic, nausea, and bilious emesis after meals. She denied past medical history except symptomatic gallstones. She was 1 week postpartum. Her total bilirubin was 4.5 mg/dl (normal, 0.2–1.3); alkaline phosphatase, 399 U/l (normal, 38–126); aspartate aminotransferase, 237 U/l (normal, 13–40); alanine aminotransferase, 267 U/l (normal, 10–40); and the blood eosinophil count was 0.58 × 109/l (normal, 0.00–0.54).

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