Portal hypertensive biliopathy and bile duct varices presenting as jaundice

A 61-year-old woman with advanced alcoholic liver cirrhosis (Child – Pugh score: C, 10 points; MELD score: 24 points) developed evident jaundice with prevalent conjugated hyperbilirubinemia (bilirubin: total 12.0 mg/dL, direct 7.5 mg/dL). Aminotransferases were only mildly elevated (AST 76 U/L, ALT 40 U/L), while there was a predominant elevation of alkaline phosphatase (162 U/L) and γ-glutamyl transpeptidase (103 U/L). Routine laboratory...