Question

A 29 year old female medical student comes to her physician with gallstones after serving as a model patient for a demonstration of abdominal ultrasound techniques. The stones were located within the gallbladder, and the patient was surprised at this finding, because she never had experienced any pain. Physical examination reveals a comfortable, afebrile, obese female. Murphy's sign is negative. Laboratory examination shows the following: WBC 7.0 K/mm3; albumin 4.2 g/dL; Alkaline phosphatase 72 U/L; ALT 16 IU/L; AST 19 IU/L; total bilirubin 0.3 mg/dL; conjugated bilirubin 0.1 mg/dL; lipase 18 U/L (normal: 10-140 U/L). Which of the following is the most appropriate next step in the management of this patient?

A. Reassurance
B. ERCP
C. Abdominal CT
D. Ursodeoxycholic acid
E. Cholecystectomy

Answer 1

The most appropriate next step in the management of this patient would be Cholecystectomy, which is the surgical removal of the gallbladder.

Step-by-step explanation:

The most appropriate next step in the management of this patient would be Cholecystectomy, which is the surgical removal of the gallbladder. The patient has gallstones within the gallbladder and although she has never experienced any pain, the presence of gallstones increases the risk of complications such as cholecystitis, gallbladder infection, or obstruction of the bile duct. Cholecystectomy is the preferred treatment to prevent these complications.