In this case, the patient had a cholestatic pattern with elevated ALP and bilirubin with mild elevation in the transaminases. Abdominal ultrasound showed increased echogenicity within the liver appropriate with fatty infiltrates, and customary duct diameter was measured to be 6 mm. At the identical time, CT of the stomach with contrast showed no acute abnormalities. The patient was admitted to the hospital and started on empiric antibiotics for presumed cholangitis. Magnetic resonance cholangiopancreatography without contrast confirmed no filling defect within the biliary duct, status post cholecystectomy, bile duct diameter inside a standard range, and unremarkable liver.

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