Symptomatic cholelithiasis

(Redirected from Biliary colic)

Background

Anatomy & Pathophysiology

  • 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

Gallbladder anatomy (overview).
Gallbladder anatomy

Clinical Features

History

  • 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

Evaluation

Gallstones found incidentally on KUB (xrays are not sensitive).

Management

Disposition

  • Discharge

See Also

References