Question 247 · LEK · Surgery of the bile ducts and gallbladder
A 53-year-old male checked into emergency dept. due to painfulness within the right hypochondriac region. The pain, which appeared the day before, is paroxysmal and accompanied by nausea and vomiting. At present, the patient has fever with chills, 39.2 degrees Celsius. He also reports dark-coloured urine. On physical examination, Chelmonski symptom is positive, and yellowing of the eye sclera can be observed. Per rectum, the stool in the rectal ampulla is discoloured. Laboratory findings: Hgb 12.5 g/dl, Hct 36%, CRP 120 mgl/l, bilirubin 80 µmol/l (4.68 mg/dl). Ultrasound examination shows a common bile duct of 11 mm in diameter and a thin-wall gallbladder with numerous deposits. Indicate the right diagnosis and procedure:
- A. acute cholecystitis - laparoscopic cholecystectomy and antibiotic therapy.
- B. cholangitis - oral conservative treatment with antibiotics.
- C. cholangitis - endoscopic retrograde cholangiopancreatography and antibiotic therapy. 84 z 117 29.06.2026, 14:15 Centrum Egzaminów Medycznych https://test.cem.edu.pl/pytcem/wyswietl_baza_pdf.php
- D. acute cholecystitis - oral conservative treatment with antibiotics.
- E. diagnosis cannot be made based on the information provided; all diagnoses are equally probable.
Hint
Look for Charcot's triad and a dilated common bile duct, then consider how the obstructed bile duct should be drained.
The answer, the explanation and a note on every option are available once you log in. The account is free: topic tests, a mock exam, mistake review and statistics.
More questions on Surgery
- Indicate the false statement regarding venous ulcers of lower extremities:
- The complications of diverticular disease include:
- Indicate true statements regarding an abscess:
- The development of the gallbladder empyema may be due to:
- Which of these medical conditions should be considered in the differentiation of acute cholecystitis?
- Indicate the procedures that should be carried out at the emergency dept. when taking care of a patient diagnosed with the perforation of the peptic…