A 50 year old female is admitted with a 3 day history of worsening fever, vomiting and right upper quadrant pain. She's tender in the right upper quadrant on exam and she's Murphy's positive. She's awaiting elective interval laparoscopic cholecystectomy after previous admission for acute cholecystitis. Her white cells and CRP are very elevated. She has nonspecific LFT derangement and a normal bilirubin. She's hemodynamically, unstable and febrile on admission and requires large volumes of fluid resuscitation. She undergoes CT abdomen and it confirms inflammatory changes in the gallbladder and an organized pericholecystic collection. This be consistent with perforated acute cholecystitis.
SurgTalk is an educational podcast series designed to support the undergraduate surgical curriculum in Trinity College Dublin. Hosted by Susie O'Neill, Clinical Lecturer in Surgery, produced by Paul Quinlan and funded by The Monkstown Hospital Foundation, this is a case-based series where consultant surgeons are interviewed on their approach to common clinical presentations. This podcast may not reflect the curriculum of other universities. This podcast series is designed for educational purposes and is not a source for medical advice or expert opinion. You should consult your physician or other health care professional if you are seeking medical advice, diagnosis or treatment.
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