Symptomatic cholelithiasis

Revision as of 03:06, 2 October 2018 by Kxl328 (talk | contribs) (History)


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


  • RUQ pain that is constant, lasts 1-5hr, and then remits
  • Usually does not occur during fasting
  • Radiation to the right shoulder increases likelihood, but is not sensitive

Physical Exam

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

Differential Diagnosis

RUQ Pain


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



  • Discharge

See Also