Answer and Explanation 4

9.  The correct answer is C.  This patient likely has biliary dyskinesia.  This patient may have peptic ulcer disease but gall bladder disease has not been ruled out.  An abdominal series would not be helpful.  There is nothing in the data to suggest pneumoperitoneum or bowel obstruction.  A upper GI with small bowel follow through would be helpful only if a stricture was expected.  An ERCP would not be helpful because if the patient had a common bile duct stone, the patient would have some abnormalities on her liver function tests.