Cholysistitis - Complication of gallstones

Diagnosis

Management

Differential diagnosis

Sudden onset, severe right upper quadrant pain

90% of people with cholysistytis have gall stones

Nausea/vomiting - Common symptom of stone in the common bile duct

Postive Murphys sign

RUQ tenderness

RUQ mass - distended tender gall bladder.

Jaundice in 10% of people

Fever - Always think sepsis

Hospital admission to confirm diagnosis

Acute cholangitis

Presents with jaundice, fever, chills, abdominal pain

Acute Pancreatitis

Gastrointestinal cancer

Symptomatic gallstones

Abdominal ultrasound

Blood tests

IV fluids, ABX, analgesia

Assessment for cholesystecomy

Risk factors

Poor diet - low fibre

Obesity

Female

Increasing age

Diabetes

End stage renal disease

Peripheral vascular disease