Abstract

A 37-year-old man presented with a 1-week history of right upper quadrant pain radiating through to his back, associated with nausea and vomiting. His medical history was significant for alcohol abuse and chronic hepatitis B. He had no regular medications. He was hypotensive with a blood pressure of 92/60 mm Hg; his remaining vital signs were within normal limits with a heart rate of 88 beats per minute, respiratory rate of 16, oxygen saturation of 100% on room air, and temperature of 36.6 degrees Celsius.

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