A 44-Year-Old Man Who Has Had an Extensive Small Bowel

A 44-year-old man who has had an extensive small bowel resection for Crohn disease has been on total parenteral nutrition for two years.  He presented to the hospital with epigastric and right upper quadrant pain.  His vital signs are within normal limits.  Physical examination shows mild right upper quadrant tenderness.  An ultrasonogram shows several gallstones; an ultrasonogram performed two years ago did not demonstrate gall stones.  Which of the following is the most likely cause of his gallstones?

A) Estrogen-induced increase in cholesterol secretion
B) Gallbladder stasis
C) Hypertriglyceridemia
D) Increased enterohepatic recycling of bile acids
E) Increased red blood cell destruction

Correct Answer:

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