A 17-year-old male presented with a chief complaint of yellowing of his skin and eyes for the past year. In this time frame, he also reported pruritus, light colored stools, and dark brown urine. He also endorsed intermittent episodes of sharp, peri-umbilical abdominal pain that may last for a few minutes. His symptoms were not triggered by illness or stress. He denies using any new medications, supplements, or vitamins. He noted bruising on legs, but no other new changes in his skin. He denied fatigue, oral ulcers, fevers, chills, lightheadedness, dizziness, nausea, vomiting, diarrhea, constipation, joint paints, or urinary symptoms. There is no history of any melena, hematochezia, or hematemesis.