NE
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A 44-year-old woman comes to the physician after being treated in the
emergency department 2 weeks ago for her first episode of diverticulitis.Her condition was diagnosed by CT scan of the abdomen and treated with an outpatient course of ciprofloxacin and metronidazole. She has no previous medical history and receives no medications. The patient's recovery was uneventful and she is currently without any new complaints. She is now concerned about
multiple small gallstones that were incidentally noted on the CT scan. Of note, the gallbladder appeared otherwise normal and there was an absence of dilated ducts. She denies any problems with cholelithiasis in the past but is worried because her mother had a "gallstone infection" in the past that required surgery and intravenous antibiotics. Her temperature is 37.0 C (98.6 F), blood pressure is 140/80 mm Hg, pulse is 93/min, and respirations are
18/min. She is 60 inches tall and weighs 77 kg (169 lb). Her abdomen is nontender and nondistended with normal bowel sounds. There is no rebound or guarding. Murphy's sign is negative. Her liver is normal sized. Laboratory studiesare normal.
Which of the following is the most appropriate management of this
patient?
A. Elective laparoscopic cholecystectomy
B. Endoscopic sphincterotomy
C. Exercise and diet modification
D. Right upper quadrant ultrasound
E. Ursodeoxycholic acid
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| robin082006
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C. Exercise and diet modification
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| nadiabarati
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C
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| muzammil
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c
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| Justice
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I am a bit confused... It seems like the Q is about this asimptomatic cholelithiasis... Then the Pt has indications to (A)... But, if the Q is about management of diverticulsos, I go with (C)... Please clarify if I misread the Q.
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| hanialkhadher
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A. Elective laparoscopic cholecystectomy
The patient's recovery was uneventful and she is currently without any new complaints.
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| NE
Forum Guru
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The answer is C- asymptomatic cholelitiasis --no surgical treatment.
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