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Surgery
A 35-year-old woman is evaluated for jaundice in an emergency depament. For several days, the patient has had mild flu-like symptoms of anorexia, nausea and vomiting, fatigue, low-grade fever, and malaise. This morning, she noted that her urine was brown in color, and she has also developed moderate, steady, pain of the right upper quadrant of her abdomen. She has not had any similar episodes in the past. On physical examination, the patient is noted to be jaundiced and to have an enlarged, tender liver. Blood chemistry studies are notable for alanine aminotransferase (ALT) of 15,000 mIU/L, aspaate aminotransferase (AST) of 11,000 mIU/L, and alkaline phosphatase of 100 U/L. Which of the following is the most likely diagnosis?
Acute hepatitis
Chronic hepatitis
Gallstone disease
Hepatic cirrhosis
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