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Case 165: Urine discolouration

This is a specimen of urine taken from a man who complained recently of epigastric pain radiating through to his back.

1. What physical sign does the urine demonstrate?

2. How would you manage this problem in the emergency department?

3. Biliary ultrasound shows stones in the gallbladder. The common bile duct was 8mm in diameter with no stones seen. Next move - MRCP or straight to ERCP?