A 49-year-old woman is admitted to the hospital with abdominal pain. Physical examination reveals an epigastric pain that migrates toward the patient's right side and posteriorly toward the scapula. Radiographic examination reveals cholecystitis with a large gallstone and no jaundice. In which of the following structures is it most likely the gallstone will be located?
The Hartmann's pouch is located in the gallbladder at the junction of the neck and the cystic duct. When a gallstone is located in this area, the patient will present with pain but usually no jaundice due to no occlusion of the cystic duct. A common bile duct and/or left and right hepatic duct obstruction would cause posthepatic jaundice due to bile obstructed in the duct system. Obstruction of the pancreatic duct would cause pain in the umbilical region, not in the right upper quadrant.
Common bile duct
Hartmann pouch
Left hepatic duct
Pancreatic duct
Abdomen & Pelvis