PATHOLOGY MCQ
BILIARY
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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A 64-year-old male is TPN-dependent 2-weeks status post bowel resection for perforated duodenal ulcer. He develops right upper quadrant pain, and abdominal ultrasound suggests acute acalculous cholecystitis. Which are correct risk factors for the development of acalculous cholecystitis?
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Critical illness, parenteral nutrition, sustained narcotic therapy, and trauma
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Parenteral nutrition, history of cholelithiasis, burns, and trauma
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Critical illness, history of biliary colic, sepsis, and sustained narcotic therapy
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Previous cholecystectomy, recent surgery, sepsis, and parenteral nutrition
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Critical illness, known cholelithiasis, parenteral nutrition, and trauma
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Explanation:
Detailed explanation-1: -In acute cholecystitis, the initial treatment includes bowel rest, intravenous hydration, correction of electrolyte abnormalities, analgesia, and intravenous antibiotics. For mild cases of acute cholecystitis, antibiotic therapy with a single broad-spectrum antibiotic is adequate.
Detailed explanation-2: -Acalculous cholecystitis is defined as cholecystitis that occurs without a gallstone. This typically occurs in critically ill patients due to a combination of factors (e.g. bile stasis and hypoperfusion). Acalculous cholecystitis often goes unrecognized initially, because of intubation and sedation.
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