11-05-2008, 01:42 PM
Explanation:
The correct answer is
C. This patient with acute cholecystitis has multiple risk factors, including female gender, obesity, and a classic history of prolonged biliary colic in association with fevers. The presentation illustrated is typical and results from obstruction of the cystic duct, which drains the gallbladder.
Obstruction of the common bile duct (choice A) or the pancreatic duct (choice D) will produce acute bacterial cholangitis, which would be demonstrated by Charcot's triad, i.e., right upper quadrant pain, fever, and jaundice.
Obstruction of either the common hepatic duct (choice B) or the right hepatic duct (choice E) may give a limited episode of cholangitis but will not cause cholecystitis, since the obstruction occurs in the biliary tree above the level of the entry of the cystic duct
The correct answer is
C. This patient with acute cholecystitis has multiple risk factors, including female gender, obesity, and a classic history of prolonged biliary colic in association with fevers. The presentation illustrated is typical and results from obstruction of the cystic duct, which drains the gallbladder.
Obstruction of the common bile duct (choice A) or the pancreatic duct (choice D) will produce acute bacterial cholangitis, which would be demonstrated by Charcot's triad, i.e., right upper quadrant pain, fever, and jaundice.
Obstruction of either the common hepatic duct (choice B) or the right hepatic duct (choice E) may give a limited episode of cholangitis but will not cause cholecystitis, since the obstruction occurs in the biliary tree above the level of the entry of the cystic duct