Intermittent Right Upper Quadrant in Surgery — 42yo Woman | General Surgery | SMLE Q#11087

SMLE Question #11087

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: February 2026
A 42-year-old woman presents 2 weeks after laparoscopic cholecystectomy with intermittent right upper quadrant discomfort and generalized pruritus. Examination shows mild scleral icterus and mild right upper quadrant tenderness. She has no fever, rigors, confusion, or hypotension. Abdominal ultrasound is limited by postoperative bowel gas, and the common bile duct is not well visualized. What is the most appropriate next step in evaluation/management?

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