Description
An 85 year old man presented with a 2 week
history of jaundice, anorexia and fatigue. He had lost
8 kg weight over the previous 3 months. His medical
history included osteoarthritis with bilateral knee
replacements and a possible episode of jaundice as a
young man. His only medications were tolteradine
(detrusitol) for detrusor instability for a number of
years and nimesulide (aulin) for arthritic pain for the
previous 3 months. He denied any history of
gallstones, blood transfusions, excess alcohol intake,
shellfish consumption or over-the-counter
medications or herbal preparations. On examination
he was cachectic, icteric but apyrexial. Murphys and
Courvoisiers signs were negative.
