Question

48-Year-Old Female with Gallstones

Ms. Burton, 48, presents at the clinic complaining of abdominal pain. She is a middle-aged woman, overweight, pale and sweating, with jaundice (yellowish skin and sclerae). Her heart rate is 102 beats/min and BP is 145/98 mm Hg. She describes the pain as "severe" and "steady" over the past night, accompanied by nausea and vomiting. She sits leaning forward and indicates that the pain is in the epigastric region radiating up to the tip of the right shoulder. Ms. Burton's medical history shows that she has had several episodes of biliary colic (pain caused by gallstones going through the bile duct). She says her current pain is "sort of like that, but it's lasted longer." She says her last meal was a seven-cheese pizza the previous night, and that the pain began 3-4 hours after eating. She denies drinking or smoking.

Answer 1

This patient is likely experiencing a gallstone blockage in the bile duct, causing severe abdominal pain and jaundice. Treatment usually involves surgical removal of the gallbladder. An abdominal ultrasound can be used to confirm the diagnosis.

Step-by-step explanation:

This patient is a 48-year-old female presenting with abdominal pain, jaundice, and a history of biliary colic. Based on her symptoms and medical history, she is likely experiencing a gallstone blockage in the bile duct. Gallstones are solid particles formed from cholesterol that can obstruct the flow of bile and cause pain and jaundice. In this case, the gallstone blockage is causing her severe and steady pain in the epigastric region, which radiates to the tip of her right shoulder.

Treatment for gallstones usually involves surgical removal of the gallbladder, a procedure called cholecystectomy. This is done to prevent future gallstone related complications and relieve symptoms. If left untreated, a gallstone blockage can lead to inflammation of the pancreas, a condition called pancreatitis.

In order to confirm the diagnosis of gallstones and assess the severity of the blockage, an abdominal ultrasound can be performed.