Symptomatic cholelithiasis

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Background

Anatomy & Pathophysiology

Gallbladder anatomy
  • Gallstones are classified as cholesterol stones and pigmented stones (black and brown), and are present in approx 20% of females and 8% of males in the United States
  • These stones cause the majority of all biliary tract problems, and depending on where the stone become impacted, specific problems occur.
  • Bile flows out the gallbladder, down the cystic duct into the common bile duct, and ultimately into the 1st portion of the duodenum.

Gallbladder disease types

Clinical Features

History

Physical Exam

  • Often benign; as compared to cholecystitis, usually negative Murphy's Sign

Differential Diagnosis

RUQ Pain

Evaluation

Gallstones found incidentally on KUB (xrays are not sensitive).
  • Labs
    • LFT, CBC normal
  • RUQ Ultrasound
    • Sensitivity 84%, Specificity 99%

Management

Disposition

  • Discharge

See Also

References