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  #1  
Old 09-12-2011
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Liver Jaundice and fever and gallstones!

A 38-year-old male with 8 hours of new onset obstructive jaundice develops a temperature of 103.4 degrees Fahrenheit. He has a known history of gallstones. Which is the likely diagnosis?

A. Cholecystitis
B. Cholangitis
C. Cholelithiasis
D. Pancreatic cancer
E. Choledocholithiasis
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  #2  
Old 09-12-2011
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is it B) Cholangitis ?
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  #3  
Old 09-12-2011
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Cholecystitis i think
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Old 09-12-2011
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B cholangitis
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Old 09-12-2011
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A. Cholecystitis
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Old 09-12-2011
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I wanna say E. choledocholithiasis but I don't know...
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Old 09-12-2011
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E) Stones moved from patients history to patients common bile duct...
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Old 09-12-2011
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DDDD
Painless jaundice should rise the Dx of pancreatic cancer. especially head pancreatic cancer.
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Old 09-12-2011
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I think E too..!! but with fever... maybe A.. ascending cholangitis..!!
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Old 09-12-2011
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I think it is cholangitis .
Just read in FA .
Charcot`s triad for Cholngitis. Jaundice+Fever+RUQ Pain
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Old 09-13-2011
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It says new onset obstructive jaundice...so i think she has history of cholocystitis and a surgery...soE. Choledocholithiasis..a stone that was missed in the surgery caused the new problem

the thing that confuses me is the fever that makes b likely too//
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Old 09-13-2011
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The correct answer is B.
Obstructive jaundice from gallstones with new onset fever is cholangitis.
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  #13  
Old 09-13-2011
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the patient doesn't have abdominal pain, so how come he has cholangitis

we should always think about pancreatic head cancer when facing painless jaundice,
the only thing that doen't match is the fever....maybe this is reason why we should pick up cholangitis in this case
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Old 09-14-2011
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I think it is A.
Cholecystitis as it is acute, obstructive with fever.
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Old 09-15-2011
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Guys,

You can clear out your concepts by reading these two threads:
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  #16  
Old 09-15-2011
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C.) cholethithiasis
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Old 09-15-2011
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Quote:
Originally Posted by Hope2Pass View Post
is it B) Cholangitis ?
noo because he dont have triod(RUO pain and chills & joindice )
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Old 09-15-2011
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check this out

Jaundice and fever and gallstones!-jaundice-types-flowchart-2.jpg
click image to enlarge
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Old 09-16-2011
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Cool

A. Cholecystitis i think , with jaundice and fever, but in this case without pain, it make me confused...
but... the near answear is A. Cholecystitis
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  #20  
Old 09-16-2011
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Quote:
Originally Posted by ricko335 View Post
The correct answer is B.
Obstructive jaundice from gallstones with new onset fever is cholangitis.
Obstruction of common duct by gallstones can be present without pain in case of diabetic patient but it is not mentioned here..
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