A 40-year-old man underwent laparoscopic cholecystectomy 2 years earlier. He remains asymptomatic until 1 week before admission, when he complains of RUQ pain and jaundice. He develops a fever and has several rigor attacks on the day of admission. An ultrasound confirms the presence of gallstones in the distal CBD. The patient is given antibiotics. Which of the following should be undertaken as the next step in therapy?
The patient described has the features of Charcot's triad-jaundice, abdominal pain, and rigors, which indicates the presence of ascending cholangitis in a patient with obstructive jaundice. The patient should be treated with broad spectrum IV antibiotics and undergo ERCP, sphincterotomy, and stone extraction. If this fails, surgical exploration of the CBD will be required.
Should be discharged home under observation
Should be observed in the hospital
Undergo surgical exploration of the CBD
ERCP with sphincterotomy and stone removal
Pancreas