GI Surgery & Hepatobiliary · NEET PG Preparation Surgery
A 55-year-old female presents with right upper quadrant pain, jaundice, and intermittent fevers (Charcot's triad) of 3 days duration. Ultrasound show…
Practice question from GI Surgery & Hepatobiliary (NEET PG Preparation Surgery), with the correct answer and a step-by-step solution.
easy · MCQ · Q-9E0FEA
A 55-year-old female presents with right upper quadrant pain, jaundice, and intermittent fevers (Charcot's triad) of 3 days duration. Ultrasound shows a dilated common bile duct with multiple stones. She is admitted and started on intravenous antibiotics, but her condition deteriorates within 12 hours with the development of altered mental status and hypotension (Reynolds' pentad). What is the most urgent definitive management required?
- A.Open common bile duct exploration and T-tube insertion
- B.Urgent endoscopic retrograde cholangiopancreatography (ERCP) with biliary drainageCorrect answer
- C.Elective laparoscopic cholecystectomy after 6 weeks
- D.Percutaneous transhepatic cholangiography (PTC) after 48 hours
Solution
Acute cholangitis with hemodynamic instability (Reynolds' pentad) constitutes a surgical emergency requiring urgent biliary decompression. ERCP with sphincterotomy and stone extraction/stent placement is the gold standard.
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