Introduction

Dr. Alexis Gomez is a MedPeds trained nephrology fellow in the combined Mass General Hospital, Brigham and Women's and Boston Children's Hospital renal program. She discusses acid-based disorders which can lead to an abnormality in your pH that matters for enzymatic function. Ms B presents with subacute jaundice, vomiting, abdominal discomfort as well as an inability to tolerate POs. Her LFTs are notable for a direct hyperbillerubinemia and imaging is notable for a mass at the head of the pancreas causing biliary obstruction and colonitis.