A 40-year-old man comes to the physician due to right abdominal pain especially severe after fatty meals. He has a hsitory of recurrent same episodes which is localized to the upper quadrent. Two year ago, he had a penetrate abdominal trauma for which an extensive bowel was resected. Examination shows right upper quadrant tenderness on deep palpation. Initial laboratory studies show moderate leukocytosis with normal hepatic transaminase, amylase, and lipase levels. Ultrasound of the abdomen reveals new several mobile echogenic foci within the gallbladder lumen. . Which of the following is most likely responsible for the development of gallstones in this patient?

Question

A 40-year-old man comes to the physician due to right abdominal pain especially severe after fatty meals. He has a hsitory of recurrent same episodes which is localized to the upper quadrent. Two year ago, he had a penetrate abdominal trauma for which an extensive bowel was resected. Examination shows right upper quadrant tenderness on deep palpation.  Initial laboratory studies show moderate leukocytosis with normal hepatic transaminase, amylase, and lipase levels. Ultrasound of the abdomen reveals new several mobile echogenic foci within the gallbladder lumen.  .  Which of the following is most likely responsible for the development of gallstones in this patient?

Quizplus · Accepted Answer

Eductional Objective: The absence of normal enteral stimulation in patients receiving total parenteral nutrition leads to decreased cholecystokinin release, biliary stasis, and increased risk of gallstones.  Resection of the ileum can also increase the risk of gallstones due to disruption of normal enterohepatic circulation of bile acids.

A 40-Year-Old Man Comes to the Physician Due to Right