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[8] RUQ ultrasound Indication: : preferred first-line imaging modality in patients presenting with suspected cholangitis [8] [11] [12] Supportive findings Dilated common bile duct: See ''Diagnosis of choledocholithiasis” for details

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Common causes include: • Pernicious anemia, an autoimmune disorder hindering Vitamin B12 absorption • Gastrointestinal surgeries, like gastrectomy, impact Vitamin B12 uptake • Long-term use of certain medications, such as metformin or proton pump inhibitors • Diets lacking in Vitamin B12, often seen in vegans and vegetarians For those without a deficiency, Vitamin B12 injections are not typically recommended, as their body can naturally regulate and excrete excess amounts of the vitamin

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