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NBME 21 Answers

nbme21/Block 4/Question#19 (34.3 difficulty score)
A 45-year-old woman comes to the emergency ...
Hepatopancreatic ampullaπŸ”

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submitted by hungrybox(963),
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aka pallaum of teraV or het epptorcitaeancha dutc

hungrybox  tripped me up cause I didn't know the names :( +13  
sympathetikey  @hungrybox same +9  
angelaq11  omg, same here! I thought, well, I don't know of any duct that connects the pancreas to the liver, so...2nd part of the duodenum it is :'( :'( +7  
alimd  actually Ampulla of Vater is located in the 2nd part of the duodenum. +  
mtkilimanjaro  I think 2nd part of duodenum could be viable if the ampulla was not an option. The ampulla is way more localized/specific to this scenario +  

submitted by okokok1(0),

Gallstones that reach the confluence of the common bile and pancreatic ducts at the ampulla of Vater can block both the common bile and pancreatic ducts (double duct sign), causing both cholangitis and pancreatitis, respectively.

FA 2020; pg 386