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Ascending cholangitis — PARA MCQ

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HardSurgery - HepatobiliaryAscending cholangitisPARA

A 38-year-old woman has right upper quadrant pain, fever and jaundice. Blood pressure is 94/58 mmHg, bilirubin is raised and ultrasound shows a dilated common bile duct. What is the most appropriate management?

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Correct answer: C — Urgent admission, IV antimicrobials and biliary decompression planning

Charcot triad plus hypotension suggests severe ascending cholangitis. Management requires urgent admission, antimicrobials, resuscitation and consideration of ERCP.

Reference: Tokyo Guidelines; NICE CKS: Gallstones