Choledocholithiasis: This condition, where a gallstone lodges in the common bile duct, can cause obstruction leading to elevated bilirubin levels. The elevated lipase suggests pancreatitis, which can be triggered by a gallstone passing through or obstructing the ampulla of Vater, leading to pancreatic enzyme elevation.

Gallstone Pancreatitis: Similar to choledocholithiasis, but the primary issue is the pancreatitis caused by a gallstone. The elevated bilirubin could be due to a stone temporarily obstructing the common bile duct.
Cholecystitis with Pancreatic Involvement: Inflammation of the gallbladder (cholecystitis) can lead to nearby pancreatic inflammation or pancreatitis, especially if a stone is obstructing the cystic duct and causing increased pressure and inflammation that affects the pancreas.

Ascending Cholangitis: An infection of the bile duct, usually due to obstruction by stones. It's a medical emergency that requires prompt treatment. The elevated bilirubin and lipase could be indicative of this condition, especially if the patient shows signs of infection like fever and jaundice.
Pancreatic Cancer with Obstruction: Although less common, pancreatic cancer can cause obstruction of the bile duct (leading to elevated bilirubin) and the pancreatic duct (leading to elevated lipase). It's crucial to consider this diagnosis, especially in older patients or those with risk factors for pancreatic cancer.

Mirizzi Syndrome: A rare condition where a gallstone becomes impacted in the cystic duct and causes obstruction of the common hepatic duct, leading to jaundice. It can also cause pancreatitis if the stone obstructs the ampulla of Vater.
Sphincter of Oddi Dysfunction: A condition that affects the sphincter that controls the flow of bile and pancreatic juices into the intestine. It can cause recurrent pancreatitis and elevated liver enzymes, including bilirubin, but is less commonly associated with cholelithiasis directly.