• Card 22 / 34: A 68 year-old woman is admitted to the hospital with 3 days of right upper quadrant pain radiating to the back accompanied by fevers. She has an ultrasound which shows a thickened gallbladder wall and numerous gallstones in the gallbladder. The bile duct is not dilated. The most likely cause of this patient’s symptoms is which of the following?
    1.) Acute pancreatitis
    2.) Acute cholangitis
    3.) Acute gallstone ileus
    4.) Acute hepatitis
    5.) Acute cholecystitis

    Answer:
    5.) Acute cholecystitis

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Explanation:

Acute cholecystitis – inflammation/infection of the gallbladder. The ultrasound results are consistent with cholecystitis (thickened gallbladder wall).There are no blood tests provided that would suggest acute hepatitis or pancreatitis. Patients with a gallstone ileus have evidence of a bowel obstruction (nausea, vomiting, dilated bowel on x-rays). Acute cholangitis usually results in a dilated bile duct on ultrasound.

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Gastrointestinal Pathophysiology Self-Assessment

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Access: Public

Attribution:  Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA
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