Question 315 · LEK · Surgery of the bile ducts and gallbladder
A 44-year-old patient who 3 months earlier underwent endoscopic retrograde cholangiopancreatography with removal of choledocholithiasis and implantantion of a prosthesis into the bile ducts, and gall bladder resection, was admitted as an emergency case into the Surgery Department due to pain in the right subcostal area without peritoneal symptoms. Body temperature 39°C, heart rate 95/min, breathing rate 20/min, elevated WBC count 18,000/µl, CRP 180 mg/l. Even prior to imaging tests, it should be suspected that the patient has:
- A. gastrointestinal perforation due to migration of the bile duct prosthesis.
- B. iatrogenic interruption of the bile ducts which occurred during cholecystectomy.
- C. decompensated chronic liver disease in the form of biliary cirrhosis.
- D. cholangitis associated with an onset of sepsis. 107 z 117 29.06.2026, 14:15 Centrum Egzaminów Medycznych https://test.cem.edu.pl/pytcem/wyswietl_baza_pdf.php
- E. blockage of the common bile duct because it was clipped intraoperatively during the gall bladder removal procedure.
Hint
High fever and inflammatory markers with a biliary stent in place — what usually happens to plastic stents after a few months?
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