A 48 year old man presents with worsening pain in the upper abdomen for 1 week, in a background of yellowish discoloration of the eyes and intermittent dark urine for 2 months.
Close questioning reveals no history of similar episodes in the past, or of other medical or surgical diseases. However, he confesses that he postponed seeking medical attention until now, as he was 'scared that he might have a serious illness'.
He has never smoked, and only drinks socially. There is no history of sexual promiscuity, blood transfusions, or intravenous drug abuse.
A complete blood count is only significant for a leukocytosis of 11,000/mm3. A renal profile is within normal parameters, as are serum amylase and lipase levels.