Hepatobiliary: 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

Sample item

An elderly woman has small bowel obstruction. Abdominal radiograph shows dilated small bowel loops, air in the biliary tree and an ectopic gallstone in the right iliac fossa. What is this triad called and what is the cause?

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

The answer and the reasoning

D. Rigler triad of gallstone ileus from a cholecystoduodenal fistula

Gallstone ileus is mechanical obstruction, usually at the terminal ileum, by a large stone that has eroded from the gallbladder into the duodenum. Rigler triad comprises small bowel obstruction, pneumobilia and an ectopic gallstone. Treatment is enterolithotomy, with cholecystectomy and fistula repair done selectively.

Option by option

  • A. Beck triad of tamponade

    Beck triad is hypotension, muffled heart sounds and raised venous pressure.

  • B. Charcot triad of cholangitis

    Charcot triad is fever, jaundice and right upper quadrant pain.

  • C. Reynolds pentad of suppurative cholangitis

    Reynolds pentad adds shock and confusion to Charcot triad.

  • D. Rigler triad of gallstone ileus from a cholecystoduodenal fistula (correct)

    Correct. Obstruction, pneumobilia and an ectopic stone form Rigler triad.

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, Rigler triad of gallstone ileus from a cholecystoduodenal fistula. Gallstone ileus is mechanical obstruction, usually at the terminal ileum, by a large stone that has eroded from the gallbladder into the duodenum.

Why is "Beck triad of tamponade" not the answer?

Beck triad is hypotension, muffled heart sounds and raised venous pressure.

Why is "Charcot triad of cholangitis" not the answer?

Charcot triad is fever, jaundice and right upper quadrant pain.

Why is "Reynolds pentad of suppurative cholangitis" not the answer?

Reynolds pentad adds shock and confusion to Charcot triad.

What concept does this question test?

It tests Hepatobiliary in General Surgery. Rigler triad comprises small bowel obstruction, pneumobilia and an ectopic gallstone. Treatment is enterolithotomy, with cholecystectomy and fistula repair done selectively.

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?

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.