Fever in Surgery — 45yo Man | General Surgery | SMLE Q#11383
SMLE Question #11383
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 45-year-old man has 2 weeks of recurrent right upper quadrant and epigastric pain radiating to the back. Over the last 2 days, the pain worsened with fever and chills. For 3 days, he has noticed dark urine, jaundice, and nausea. Examination shows scleral icterus and right upper quadrant tenderness. Abdominal ultrasound shows a 14-mm common bile duct with intrahepatic ductal dilatation and an obstructing distal duct focus. What is the most likely diagnosis?
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