Which signs can indicate biliary obstruction in a patient with gallstones?

Biliary obstruction commonly occurs when gallstones migrate to the bile ducts, leading to a blockage that prevents bile from reaching the intestines. When this happens, certain physiological changes occur in the body that manifest as specific symptoms.

Dark urine is a sign of bilirubin accumulation in the blood due to the obstruction, as excess bilirubin gets filtered by the kidneys, resulting in darker urine. Similarly, jaundice is the yellowing of the skin and the whites of the eyes, which occurs because of the buildup of bilirubin in the tissues when bile cannot flow properly. Together, these signs—the dark urine and jaundice—point to a clear indication of biliary obstruction.

In contrast, the other options present symptoms that are not typically associated with biliary obstruction. Shortness of breath and chest pain may suggest cardiovascular or respiratory issues. General malaise and headaches are nonspecific symptoms that can arise from various conditions, unrelated to bile flow. Fever and cough may indicate an infection or respiratory condition, rather than highlighting any biliary problem. Therefore, the signs of dark urine and jaundice are the hallmark indicators of biliary obstruction due to gallstones.