A 55-year-old woman with a history of gallstones has fever, a tender right upper quadrant and a positive Murphy sign. Ultrasound shows a thickened gallbladder wall with stones. What is the diagnosis?
Answer and explanation
Correct answer: A. Acute cholecystitis
- Step 1: Murphy sign with a thickened wall and stones indicates cholecystitis.
- Step 2: Treatment is antibiotics with early laparoscopic cholecystectomy.
Answer
Acute cholecystitis.
Why not the others: Acute appendicitis: Appendicitis causes right iliac fossa pain. Acute peptic ulcer perforation: A perforation would cause generalised peritonitis. Acute viral hepatitis: Hepatitis does not give a positive Murphy sign with stones.
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