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Gallstone pancreatitis with cholangitis — RCPSC EM MCQ

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HardGI/Abdominal emergenciesGallstone pancreatitis with cholangitisRCPSC EM

A 66-year-old has epigastric pain radiating to the back, fever, and jaundice. Lipase is 3100 U/L, bilirubin is 110 micromol/L, ALT is 280 U/L, and ultrasound shows gallstones with a dilated common bile duct. What is the most appropriate next step?

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Correct answer: B — Resuscitate, give antibiotics, and arrange urgent ERCP

Resuscitate, give antibiotics, and arrange urgent ERCP is correct: the clues indicate Gallstone pancreatitis with cholangitis and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian pancreatitis and biliary sepsis practice