3 Days Of Epigastric in Surgery — 60yo Man | General Surgery | SMLE Q#11605

SMLE Question #11605

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: February 2026
A 60-year-old man presents to the emergency department with 3 days of epigastric and right upper quadrant pain with nausea. Over the last 24 hours, he developed fever with rigors and noticed yellowing of his eyes. He is icteric with right upper quadrant tenderness and a positive Murphy sign. Abdominal ultrasound shows multiple gallstones, mild gallbladder wall thickening, and a common bile duct diameter of 9 mm. What is the most likely diagnosis?

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