A 49-year-old lady is transferred to the ICU with hypertension and decreased level of … after being admitted with a 3-day history of RUQ abdominal pain, high-grade fever … yellowish sclera discoloration with dark urine. Ultrasound reveals dilated CBD & intra-h… ducts. No gastroenterologist or interventional radiologist is available. The next most appropriate management is:
سؤال مجاني 8 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: A. Choledochotomy and T-tube insertion.
- إجابة ثانية: C. Cholecystectomy and common bile duct (CBD) exploration.
Confusion and shock on top of Charcot's triad make this Reynolds pentad: suppurative cholangitis that needs urgent biliary decompression. ERCP and PTC are the usual routes. With no endoscopist or interventional radiologist available, the surgical option is laparotomy, choledochotomy and T-tube drainage.
- A cholecystostomy (B) drains the gallbladder, not the obstructed CBD.
- Adding a cholecystectomy (C, D) lengthens surgery in an unstable septic patient. The sources describe only decompression here, so the bank's C is not supported.
The older bank was corrected by Batch 40 to C (adding cholecystectomy); only Surgical Recall covers this exact scenario, so both answers are shown.
- المصدر
- Surgical Recall biliary tract.pdf · p. 15
Gallbladder Conditions -.pdf · p. 7 - المحاضرة
- Gallbladder Conditions · General Surgery · Module D
- ظهر في
- Surgery QB (Module D) p. 78 Q39