A 60-year-old male presents with persistent right upper quadrant pain for the past 5 hours. The pain is severe, steady, and associated with nausea and vomiting. He has a fever and appears jaundiced. What are the potential diagnoses and next steps?
This patient's presentation suggests a complication of gallstones such as acute cholecystitis (inflammation of the gallbladder) or choledocholithiasis (gallstone in the common bile duct) with potential cholangitis (infection in the bile duct). Blood tests should be obtained, including complete blood count, liver function tests, and pancreatic enzymes. Imaging with an abdominal ultrasound is a crucial next step, and if choledocholithiasis with cholangitis is suspected, an ERCP (Endoscopic Retrograde Cholangiopancreatography) may be necessary for both diagnosis and treatment.