Male patient 70 years old diabetic on insulin known HCV and medical treatment was given 2 years ago
Complain : Rt hypochondrial pain
14 days ago
Severe fatigue
Examination :
Rt hypochondrial tenderness
Tinge of jaundice
Feverish
Ultrasonography done and revealed acute on top of chronic calcular cholecystitis
Also described marked odema of the wall of gall bladder
Laparotory investigations requested and revealed
Urea : 112
Creatinine 
:3
CBC : TLC 22000. Platelets:77000
Alkaline phoshatase : 77
CRP :12
ALT and AST were 3 folds
Bilirubin : normal although clinically there is tinge of jaundice in sclera
Conservative medical treatment with nephrology and hepatolog consultation were done for 5 days
Then laboratory investigations were requested and revealed
CBC :TLC 7000. Platelets 155000
Urea 58. Creatinine 1.5
CRP 96
Alkaline phosphatase 9000
ALT AST. Mild elevation
Bilirubin normal
Patient clinically fairly improved
General Condonion
Pain and anorexia disappear
No fever
Blood glucose level controlled less than 200
What about diagnosis
Plane of management