Case library

A 46-year-old woman is on day 2 after an elective laparoscopic cholecystectomy for symptomatic gallstones. Overnight the subhepatic drain has produced 300 mL of bile-stained fluid. She is comfortable at rest but has mild right upper quadrant pain, a pulse of 96 and a temperature of 37.8 °C.

A 24-year-old man presents with five days of periumbilical pain that has moved to the right iliac fossa, anorexia and vomiting. He is febrile at 38.4 °C with a tender, ill-defined mass in the right iliac fossa. White cell count is 16.8 ×10⁹/L and CRP 180 mg/L.