A 56-year-old woman with a history of cholecystitis presents with jaundice and severe pruritus for 3 days. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C, SpO2 98%. Laboratory studies reveal direct bilirubin 4.2 mg/dL, alkaline phosphatase 320 U/L, and normal transaminases. Abdominal ultrasound shows dilated common bile duct (8 mm) with gallstones; no hepatomegaly noted. Which diagnosis best explains her presentation?
- A)CholedocholithiasisGABARITO
- B)Gilbert syndrome
- C)Primary biliary cholangitis
- D)Hemolytic anemia
- E)Acute appendicitis
Explicação
Choledocholithiasis is obstruction of the common bile duct by gallstones and produces a cholestatic pattern with direct hyperbilirubinemia, elevated alkaline phosphatase, jaundice, and pruritus. Dilation of the common bile duct on imaging supports extrahepatic... Ver explicação completa e trilha adaptativa →