disease | Calculous Cholecystitis |
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bubble_chart Overview It refers to the disease caused by the formation of stones in the gallbladder or the neck of the gallbladder. Its clinical manifestations depend on the location and size of the stones, whether they cause infection or obstruction, as well as the location and degree of the obstruction.
bubble_chart Diagnosis
1. History Taking
- Gallstones in the gallbladder generally do not cause symptoms of biliary colicky pain and are referred to as silent stones. They may present with symptoms of dyspepsia such as dull pain in the right upper abdomen, acid reflux, belching, abdominal distension, and fullness, which are more pronounced after consuming greasy foods. If accompanied by infection, symptoms of acute cholecystitis may occur.
- Stones in the cystic duct may manifest as biliary colicky pain, characterized by sudden-onset, persistent pain in the right upper abdomen with paroxysmal exacerbations, radiating to the shoulder and back, accompanied by nausea and vomiting. For detailed inquiry points, refer to acute and chronic cholecystitis.
2. Physical Examination Findings
- Gallstones in the gallbladder may show no positive signs, though in rare cases, an overly large stone may be palpable.
- In cases of cystic duct stones, there is tenderness in the right upper abdomen, a positive Murphy's sign, and an enlarged, tender gallbladder may be palpable. If gallbladder perforation occurs, signs of acute peritonitis such as generalized abdominal tenderness, rebound tenderness, and muscle guarding may be present. Some patients may develop jaundice.
3. Laboratory Tests
For details, refer to acute and chronic cholecystitis. If gallbladder perforation occurs, abdominal plain films may reveal free air under the diaphragm.
4. Differential Diagnosis For details, refer to acute and chronic cholecystitis.
bubble_chart Treatment Measures
See acute and chronic cholecystitis.