Hepatobiliary Disease USMLE Step 1 Practice Question
An 81-year-old woman presents with progressive abdominal distension, bilious vomiting, and obstipation for 3 days. Vital signs show BP 138/82, HR 98, RR 20, temperature 37.2°C, SpO2 98% on room air. Abdominal examination reveals distension without peritoneal signs. CT imaging demonstrates small bowel obstruction, pneumobilia, and an ectopic calcified gallstone impacted near the ileocecal valve. Laboratory studies show normal liver function tests. Which of the following is the most likely diagnosis?
Answer choices
- AVolvulus
- BAcute cholecystitis
- CGallstone ileusCorrect answer
- DIntussusception
- EAdhesive small bowel obstruction
- FCrohn's disease with stricture formation
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