Table 1 Differential diagnoses of biliary-tract disease in pregnancy.

From: Biliary sludge and acute pancreatitis during pregnancy

  Clinical features Ultrasonography Serum transaminase level Serum bilirubin level Serum amylase and lipase levels
Biliary colic Abdominal pain, nausea, vomiting, no fever Gallbladder sludge or stones, no biliary ductal dilation, normal gallbladder wall thickening Normal Normal Normal
Acute cholecystitis Abdominal pain, nausea, vomiting, fever, Murphy's sign Abnormal gallbladder wall thickening, pericholecystic fluid, sonographic Murphy's sign Mild elevation Normal Normal
Acute cholangitis Abdominal pain, fever, jaundice, mental status changes Biliary ductal dilation Mild elevation Elevated Normal
Acute pancreatitis Abdominal pain, nausea, vomiting, mild fever Can show biliary sludge or stones Mild elevation Mild elevation unless biliary obstruction also present Elevated
Acute fatty liver of pregnancy Right upper abdominal quadrant pain, mental status changes, renal failure Can show fatty infiltration of the liver 500 U/l <85 μM Normal
HELLP syndrome Abdominal pain, hypertension, peripheral edema, thrombocytopenia Can be normal 500 U/l <85 μM Normal
  1. HELLP, hemolysis, elevated liver enzyme levels, low platelet count syndrome.