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A 65-year-old male patient presents with a 2-day history of diffuse colicky abdominal pain originating in the RUQ. It is not aggravated by food or activity. There has been nausea, but no vomiting. Skin and eyes have turned yellow. Urine has been dark brown, and stools have been white and chalky. He smokes 2 cigarettes daily. He stopped drinking alcohol 2 years ago and has been sober since. Gallstones were diagnosed when he stopped drinking, but he refused surgery. There is a history of previously diagnosed untreated hypertension. There was an episode of "shaking chills" earlier today. When he walks, he gets dizzy. Temperature 103°F; pulse 115/min; blood pressure 100/65 mm Hg; respirations 32/min (labored); pulse ox 90%. He is mildly icteric. The abdomen is slightly protuberant, and there is tenderness and rebound tenderness restricted to the RUQ.What is the most likely cause of this patient's primary issue?
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