GALLSTONES (acute Biliary Colic)Classic Symptoms:
- RUQ abdominal pain
- Radiates to right back or shoulder
- Nausea / vomiting
- RUQ tenderness
- ? positive Murphy’s sign (palpate deep in RUQ as pt takes slow breaths; suddenly they freeze & gasp)
- Recurrent episodes of severe upper abdominal pain lasting <12 hours
- Pain peaks over 1 hr, subsides similarly.
- Often with associated nausea / vomiting
If symptomatic during presentation, LFTs may be elevated (esp. Alk Phos)
Dx by image: Ultrasound preferred over CT
Send to ER: Fever, jaundice
ACUTE CHOLECYSTITIS, CHOLANGITIS
- Prolonged severe pain (>1 day) with positive Murphy’s
- Fever, jaundice
Send to ER.
See posting Abdominal Pain – 1.