Acute cholecystitis Quiz: Ace Your Exams
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A 72-year-old hospitalized man is evaluated for abdominal pain, jaundice, and fever. He was admitted two weeks ago for coronary artery bypass surgery, which was complicated by mediastinitis. He underwent surgical debridement and is now receiving IV antibiotics and total parenteral nutrition. Medical history is significant for hypertension, type 2 diabetes mellitus, and congestive heart failure. He has had no history of gallstones or abdominal pain. For the past 24 hours, the patient has been experiencing fever, abdominal pain, right shoulder pain, nausea, and vomiting. Today, the nurse noticed he began to develop mild jaundice of the skin. Temperature is 38.5°C (101.3°F), pulse is 102/min, and blood pressure is 135/85 mmHg. BMI is 35 kg/m2. Leukocyte count is 17,000 mm3. During imaging, respiratory arrest is observed when the ultrasound probe is applied over the right subcostal area; ultrasound results are equivocal due to body habitus. Laparoscopic surgery is planned. Which of the following set of findings is most likely to be seen in this patient during surgery?
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