Symptomatic cholelithiasis

Diagnosis

1. History
   1. RUQ pain that is constant, lasts 1-5hr, and then remits
      1. Pain >5hr suggests cholecystitis, cholangitis, or pancreatitis
   2. Usually does not occur during fasting
2. Physical Exam
   1. Often benign; as compared to cholecystitis, usually negative Murphy's Sign
3. Labs
   1. LFT, CBC normal
4. Ultrasound
   1. Sensitivity 84%, Specificity 99%

Treatment

1. IV/IM Ketorolac (as effective as meperidine) with Rx for Ibuprofen

Source

• UpToDate
• Tintinalli

See Also

• Gallbladder Disease (Main)
• Ultrasound: Gallbladder