Question

A 65-year-old obese female presents to the emergency room complaining of severe abdominal pain. She reports pain localized to the epigastrium that radiates to the right scapula. The pain occurred suddenly after a fast food meal with her grandchildren. Her temperature is 100.9°F (38.2°C), blood pressure is 140/85 mmHg, pulse is 108/min, and respirations are 20/min. On examination, she demonstrates tenderness to palpation in the epigastrium. She experiences inspiratory arrest during deep palpation of the right upper quadrant but this exam finding is not present on the left upper quadrant. A blockage at which of the following locations is most likely causing this patient's symptoms?

a. Common hepatic duct
b. Ampulla of Vater
c. Cystic duct
d. Pancreatic duct of Wirsung
e. Common bile duct

Answer 1

The blockage at the Ampulla of Vater is most likely causing this patient's symptoms of severe abdominal pain.

Step-by-step explanation:

The blockage at the Ampulla of Vater is most likely causing this patient's symptoms. The information provided indicates that the patient is experiencing severe abdominal pain localized to the epigastrium that radiates to the right scapula. The presence of inspiratory arrest during deep palpation of the right upper quadrant suggests a blockage in that area. The Ampulla of Vater is the common channel where the common bile duct and pancreatic duct join before emptying into the duodenum.