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Acute cholangitis — ABEM Board MCQ

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HardGI/Abdominal emergenciesAcute cholangitisABEM Board

A 48-year-old man arrives as ESI 2 with fever, jaundice, and right upper quadrant pain. BP 92/54, HR 124, WBC 19,000/mcL, bilirubin 5.8 mg/dL, and ultrasound shows a dilated common bile duct. Which of the following is the most likely diagnosis?

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Correct answer: DAcute cholangitis

Charcot triad with hypotension and obstructed bile duct supports acute cholangitis.

Reference: Tokyo Guidelines 2018; ACG biliary infection guidance