Worsening Right Upper Quadrant in Surgery — 72yo Woman | General Surgery | SMLE Q#945

SMLE Question #945

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: February 2026
A 72-year-old woman presents to the emergency department with worsening right upper quadrant pain 2 weeks after a percutaneous cholecystostomy for acute cholecystitis. She has localized right upper quadrant tenderness without peritonitis. Contrast-enhanced CT abdomen shows a large subhepatic fluid collection adjacent to the gallbladder fossa with no free intraperitoneal air. What is the most appropriate initial management of this subhepatic collection?

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