Here is the patient’s clinical course:
RUQ ultrasound was obtained and it showed gallstones within the gallbladder, without stranding and a negative Murphy’s sign. The common bile duct was 6mm (non-dilated).
Aggressive early hydration with lactated ringers was initiated along with anti-emetics and analgesics. Six hours after arrival given improved nausea and pain, a clear liquid diet was initiated. Repeat labs at 24 hours were notable for improvement in BUN from 60 -> 30 mg/dL and HCT from 48 -> 36%. Patient was gradually advanced to regular low fat diet by end of day 2 of admission. On Day 3 patient was taken for a laparoscopic cholecystectomy and thereafter discharged home.
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Case 7 Index:
Introduction
Physical Exam
Differential Diagnosis
Diagnostic Testing
Management
GI SIM 