Case

A 47 year old patient is brought to the ER complaining of pain in their upper right abdominal quadrant. You note that the patient has a slight fever and yellow tint to their eyes. The patient reports their urine is a dark coloration and their stool light tan in color.  The patient first noticed the symptoms approximately a week ago.

Question 1/2 - What is your primary diagnosis?

Click on your selected option(s) below  (correct = 1, over-thinking = 2+)

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Less likely in this case. Non-obstructive jaundice (symptoms of urine darkening, stool lightening, and yellow tint to the eyes) has a variety of causes (more to come in the Digestion course later in MS1), but it typically non-painful, so would be less likely given the patient reports pain and inflammation (recognized as their having slight fever).

Less likely in this case. While a head of the pancreas cancer can cause jaundice (symptoms of urine darkening, stool lightening, and yellow tint to the eyes), cancers are typically non-painful, so would be less likely given the patient reports pain and inflammation (recognized as their having slight fever).

Correct!  Gallstones commonly present as painful jaundice (upper right quadrant typically), often with inflammation (recognized as their having slight fever) with the typical jaundice symptoms (urine darkening, stool lightening, and yellow tint to the eyes). 

Incorrect. Ischemic colitis is a lack of blood flow to the intestinal tract resulting in ischemia and possibly necrosis of organ tissues. It can progress rapidly, but would not affect urine or eye color with the pain more generalized rather than upper right quadrant.

Incorrect.  An aneurysm is often asymptomatic until it starts to leak. When an aneurysm leaks blood that generates retroperitoneal and/or intraperitoneal irritation. It would not affect urine, feces or eye coloration and the pain would be more generalized rather than upper right quadrant.