Hepatobiliary and pancreatic surgery: acalculous cholecystitis: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary and pancreatic surgery: acalculous cholecystitis

Sample item

A critically ill burns patient on parenteral nutrition for three weeks develops fever and right upper quadrant tenderness. Ultrasound shows a distended gallbladder with a thick wall and pericholecystic fluid but no stones. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Acute acalculous cholecystitis

Critical illness, burns, prolonged fasting and parenteral nutrition cause bile stasis and ischaemia, leading to acalculous cholecystitis. It has a high risk of gangrene and perforation, and treatment is cholecystectomy or percutaneous cholecystostomy if unfit.

Option by option

  • A. Acute calculous cholecystitis

    Calculous cholecystitis needs stones, which are absent.

  • B. Hepatic abscess

    An abscess would show a focal intrahepatic collection.

  • C. Ascending cholangitis

    Cholangitis needs ductal obstruction and jaundice.

  • D. Acute acalculous cholecystitis (correct)

    Correct. Inflammation without stones in a critically ill patient fits acalculous disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Acute acalculous cholecystitis. Critical illness, burns, prolonged fasting and parenteral nutrition cause bile stasis and ischaemia, leading to acalculous cholecystitis.

Why is "Acute calculous cholecystitis" not the answer?

Calculous cholecystitis needs stones, which are absent.

Why is "Hepatic abscess" not the answer?

An abscess would show a focal intrahepatic collection.

Why is "Ascending cholangitis" not the answer?

Cholangitis needs ductal obstruction and jaundice.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: acalculous cholecystitis in General Surgery. It has a high risk of gangrene and perforation, and treatment is cholecystectomy or percutaneous cholecystostomy if unfit.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary and pancreatic surgery: acalculous cholecystitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.