Today’s topic of discussion - gall stones & it’s presentations
-
Investigation of choice for calculous cholecystitis?
a. USG
b. HIDA scan
c. NCCT -
36 year old patient presents with right hypochondrial pain for last 72 hours and she has severe tenderness on palpation in the right hypochondrium. USG reveals a thickened GB with stones and pericholecystic fluid. Which class of cholecystitis does this patient fall under according to the new Tokyo guidelines?
a. mild
b.moderate
c. severe -
Patient comes to the OPD with a diagnosis of cholelithiasis and a dilated CBD. on MRCP, stones are found in the CBD as well. What is the best method to treat this patient?
a. ERCP and removal of stones followed by lap chole
b. lap chole plus lap exploration of CBD
c. lap chole followed by ERCP -
IOC for CBD stones
a. ERCp
B. MRCP
c. NCCT
d. USG -
Patient undergoes an uneventful lap cholecystectomy. 24 hours later patient complains of severe pain in right hypochondrium and USg reveals collection in GB fossa. Patient starts running fever soon after. MRCP reveals a partial CBD injury. What is the ideal management in this patient
a. ECRP and stenting
b. re-explore and repair the CBD with insertion of drain
c. re-explore and roux en y hepaticojejunostomy
d. only drain insertion in GB fossa
Answers will be posted tomorrow morning with explanations.
If you have any queries regarding this topic, please post in the comments section.