Case 265.

History A 70-year-old man presented to the emergency department with fever, chills, rigors, and upper abdominal discomfort. Physical examination revealed jaundice and mild right upper quadrant tenderness. Laboratory tests revealed an increased C-reactive protein level of 133 mg/L (normal range, 0.2-0.9 mg/L), a white blood cell count of 11.69 ×10