ROSH Gastrointestinal Practice Exam

What condition is most likely diagnosed in a patient with a history of ethanol abuse presenting with nausea, vomiting, and significant hepatomegaly?

1. Acute viral hepatitis

2. Alcoholic hepatitis

3. Ascending cholangitis

4. Cholecystitis

The correct answer is: Alcoholic hepatitis

The condition most likely diagnosed in a patient with a history of ethanol abuse presenting with nausea, vomiting, and significant hepatomegaly is alcoholic hepatitis. This diagnosis aligns closely with the patient’s history of alcohol use and the clinical symptoms displayed. Alcoholic hepatitis is characterized by inflammation of the liver due to excessive alcohol consumption, leading to symptoms such as nausea, vomiting, and abdominal pain. Hepatomegaly, or liver enlargement, occurs as the liver cells become damaged and inflamed. In patients with a significant history of ethanol abuse, the development of alcoholic hepatitis is a common consequence of chronic alcohol consumption, making it a highly relevant diagnosis in this scenario. Other conditions listed, such as acute viral hepatitis, might show similar symptoms, but they are less likely given the specific context of a history of ethanol abuse combined with the presentation of hepatomegaly. Additionally, ascending cholangitis and cholecystitis are related to biliary obstruction and inflammation of the gallbladder, which would not directly correlate with the history of alcohol abuse or the specific symptoms of hepatomegaly.