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Gallstones (Other presentations (Obstructive jaundice with CBD stones (If…

- - - - fat
      - female
      - fertile
      - forty
      - fair
- - - - lay 2 fingersover the RUQ & ask them to inspire
      - this causes pain :frowning_face: and arrest of inspiration
      - only :heavy_plus_sign: if :heavy_minus_sign: on LUQ
  - - - :arrow_up: WCC
    - - thick walled, shrunked GB
      - pericholecystic fluid
        (fluid around GB)
      - stones
      - dilated common
        bile duct >6mm
- - - - Image stones
        & assess diameter
    - - find common bile duct stones
  - - - if CBD has stones
- - - - RUQ pain
      - jaundice
      - rigors
    - - Cefuroxime
      - and metronidazole
  - - - pneumobilia - air in the CBD
      - small bowel fluid levels
      - stone
  - - - sickle cell
      - diabetes
      - immunosuppression
      - calcified / porcelain GBs