BOF 78

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BOF: 78

A 26 year old male who is known to have sickle cell anaemia presents with abdominal pain. He has not been on any medication and he has not abused illicit drugs or alcohol.

On examination he is in pain, febrile, pulse 110 beats per minute, BP 120/80 heart sounds were normal, lungs were clear. On examination of his abdomen he was tender in the right hypochondrium, there were no lumps palpable nor was there any organomegaly, bowel sounds were normal.

Investigations

Hb 8 g /dL

WBC 14 x10⁹ /L

Platelets 450 x10⁹ /L

ALT 35U/L

Alkaline phosphatase 175 U/L

Bilirubin 58 µmol/L

In this patient which one of the following investigations would you arrange in order to reach a diagnosis?

a)      Chest X-ray

b)      Serum amylase

c)      Upper GI endoscopy

d)     Abdominal ultrasound scan

e)      ERCP

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