Question 20 / 32:  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?

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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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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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