### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi. I had an emergency cholecystectomy 2011 for which I went to the ER for 3 times in 2011 with RUQ pain & nausea and was sent home and told that I was fine. I was not. My 4th visit to the ER in 2011 resulted in a ruptured gallbladder w/infection of gangrene. I was seen yesterday in my local ER for chest pain, shortness of breath, tachycardia, nausea, vomiting, headache, tingling in my fingers, fluctuating weight & my sense of taste made everything I ate taste salty. I have also had a chronic itchy rash/hives for many months now. The doctor tried to see if I had any abdominal pain but I did not at the time. One of my liver enzymes was elevated. They could not find any cardiopulmonary issues (other than a Hx of Sarcoid) so they sent me home. My mother also had a bile duct obstruction and she did not have any abdominal pain symptoms either, however she did end up having an emergency ERCP. Today I still do not feel well & I know my body- there is something wrong with me. I know you don t have my chart in front of you but do you think I should be concerned about this possibly being a bile obstruction?

### output:

Madam, your doubt as to bile obstruction following emergency cholecystectomy of 2011 requires to be looked with two angles when they are persisting symptoms we recognize as PCS. The biliary causes usually manifest fairly early following surgery and demand an imaging to guide the location and lesion in bile path. MRCP is preferred to know these problems. If this proves non-indicative in your case, a look-out for other unrelated but mimicking pathology will be unmasked by Enhanced CT abdomen. Since your mother also had similar sequence, a probable functional obstruction at the pancreatic sphincter may be known when you undergo biliary scintigraph and/or manometry.