question: Woman, 38 yrs old, 84 kg. 8 months with right upper quadrant pain, negative Murphy s sign, positive right fist percussion, klebsiella pneumoniae in developing urinalysis ( 100,000 U / ml), 3 cm cyst in right ovary, abdominal and thoracic radiographs normal, hepatomegaly , NSAIDs paracetamol codeine, diarrhea, metrorrhagia , menorrhagia, acalculous gallbladder, loss of 12 kg in the first two weeks, worsens with activity