PATHOLOGY MCQ
BILIARY
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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A 65-year-old man with a history of cholecystitis previously managed by percutaneous cholecystostomy (3 years ago), coronary artery disease status post drug-eluting stent placement (most recently 2 years ago), chronic obstructive pulmonary disease, and dyslipidemia presents with a high-grade small bowel obstruction. Nonoperative management by nasogastric decompression is unsuccessful, and the patient is taken to the operating room for exploration. A firm, stonelike, mobile intraluminal mass is palpated in the distal ileum, 10 cm proximal to the ileocecal valve. The bowel appears mildly dilated and well perfused. What is the correct next maneuver?
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Small bowel resection and stapled side-to-side functional end-to-end anastomosis with 5-cm margin
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Enterotomy with removal of the stone and transverse two-layered closure
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Small bowel resection with handsewn anastomosis and cholecystectomy
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Diverting loop ileostomy
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Explanation:
Detailed explanation-1: -Contraindications There are no absolute contraindications to percutaneous cholecystostomy. Relative contraindications of PC include hemorrhage or uncorrectable bleeding diathesis, and pericholecystic abscess. A gallbladder filled with stones might prevent catheter insertion.
Detailed explanation-2: -Percutaneous cholecystostomy (PC) is employed for the treatment of various gallbladder conditions including biliary emergencies such as cholecystitis or cholangitis, malignant or benign biliary obstruction, gallbladder perforation, and percutaneous biliary stone removal.
There is 1 question to complete.