A 59-year-old woman comes to the physician for a 6-month history of intermittent abdominal pain and yellow eyes. She has smoked one pack of cigarettes daily for 40 years. She drinks whisky periodically. Vitals are: temperature 100.0 F, HR 72, RR 16, BP 130/90. Sudan black stain of the stool is negative. Laboratory studies show:
Total bilirubin 3.0 mg/dL
Alkaline phosphatase 300 IU/L
Amylase 1200 U/L (NR 30-110)
Which of the following is the most likely explanation for these findings?
Cholecystitis
Choledocholithiasis
Cholelithiasis
Head of pancreas adenocarcinoma
Pancreatitis (chronic)
