A 65-year-old male with known gallstones presents with right upper quadrant pain, fever, and confusion. His blood pressure is 90/60 mmHg, heart rate is 110 beats/min, and temperature is 39°C. What are the potential diagnoses and next steps?
This patient's presentation suggests gallstone-related sepsis, potentially from acute cholecystitis or cholangitis. This is a serious condition that requires urgent evaluation and treatment. Initial management should include intravenous fluid resuscitation and broad-spectrum antibiotics. Diagnostic tests should include blood cultures, liver function tests, and an abdominal ultrasound to visualize the gallbladder and biliary tree. Depending on the findings, the patient may require an emergency cholecystectomy or ERCP.