A man has fever, jaundice and right upper quadrant pain (Charcot triad). What is the most likely diagnosis?
Answer and explanation
Correct answer: A. Ascending cholangitis from an obstructed, infected common bile duct
- Step 1: Fever, jaundice and right upper quadrant pain together indicate infected, obstructed bile. Step 2. Hypotension and confusion added to the triad form Reynolds pentad and signal severe disease. Answer: Ascending cholangitis. Why not the others: Hepatitis rarely causes this triad. Pancreatitis causes epigastric pain. A perforated ulcer causes a rigid abdomen.
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