A 52-year-old woman presents 48 hours after onset of RUQ pain, fever and positive Murphy’s sign. Ultrasound shows thickened gallbladder wall and pericholecystic fluid. She is stable. Best management?
Anonymous Quiz
62%
A) Conservative treatment then interval cholecystectomy after 6 weeks
33%
B) Early laparoscopic cholecystectomy during same admission
5%
C) Immediate ERCP
0%
D) Percutaneous cholecystostomy only
❤1
Which factor MOST increases technical difficulty during laparoscopic cholecystectomy?
Anonymous Quiz
4%
A) Female gender
4%
B) Age <50 years
36%
C) Gallbladder wall thickness >5 mm
56%
D) All of the above
A patient with obstructive jaundice, imaging shows a stone impacted in Hartmann’s pouch compressing the CBD. Diagnosis and best treatment?
Anonymous Quiz
18%
A) Choledocholithiasis — ERCP with stone extraction
65%
B) Mirizzi syndrome — Cholecystectomy ± endoscopic relief of obstruction
15%
C) Ascending cholangitis — ERCP with sphincterotomy and drainage ± stone extraction
3%
D) Benign biliary stricture — Endoscopic dilatation
A 68-year-old diabetic man presents with RUQ pain, fever, positive Murphy’s sign, and leukocytosis. CT shows gas within the gallbladder wall. What is the most likely diagnosis?
Anonymous Quiz
5%
A) Uncomplicated acute calculous cholecystitis
5%
B) Acalculous cholecystitis
5%
C) Biliary colic
86%
D) Emphysematous cholecystitis
Which condition predisposes specifically to pigment stone formation?
Anonymous Quiz
12%
A) Obesity
73%
B) Chronic hemolysis
8%
C) Rapid weight loss
8%
D) Oral contraceptive use
A patient underwent laparoscopic cholecystectomy. On day 2, he develops jaundice and abdominal pain. Most concerning complication?
Anonymous Quiz
35%
A) Bile duct injury
12%
B) Retained cystic duct stone
23%
C) Post-cholecystectomy syndrome
31%
D) All of the above
The following statements are true except
Anonymous Quiz
4%
A. The peak incidence of acute appendicitis is in the teens and early 20s.
22%
B. The incidence of acute appendicitis is lowest in those who have a high intake of dietary fibre
17%
C. Obstruction of the appendix lumen by a caecal carcinoma might give rise to acute appendicitis.
9%
D. Aerobic and anaerobic organisms are responsible for acute appendicitis.
48%
E. A mucocele of the appendix is a clinical variation of acute appendicitis.
Forwarded from Surgical Practice Dr. alqhatani (彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡)
TG18.apk
5.3 MB
✅ Practical Guidelines for diagnosis and management of cholecystitis and cholangitis
Tokyo Guidelines
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#clinical
@Surgery_Practice
Tokyo Guidelines
–––––––––––––
#clinical
@Surgery_Practice