Figure it out fridays
A 42-year-old male with a history of cerebral palsy, learning difficulties and epilepsy was admitted with a 24-h history of nausea, vomiting and abdominal pain.
Past surgical history:
-Laparoscopic cholecystectomy with operative cholangiogram 9 years previously
-Laparotomy and drainage of a pancreatic pseudocyst 16 years previously
On examination: midline laparotomy scar and a distended, tender abdomen.
Elevated liver function tests:
ALP 285 U/l
ALT 465 U/l
GGT 669 U/l
with a normal bilirubin.
Magnetic resonance cholangiopancreatography done (image above)
What is your diagnosis?
E. Foreign body