Gallstone disease physical examination: Difference between revisions
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'''HEENT''' | '''HEENT''' | ||
* Icteric sclera | |||
[[Image:jaundice1.jpg|thumb|left|500px|Source: Wikipedia<ref name="urlJaundice - Wikipedia">{{cite web |url=https://en.wikipedia.org/wiki/Jaundice#/media/File:Jaundice08.jpg |title=Jaundice - Wikipedia |format= |work= |accessdate=}}</ref>]] | |||
* Icteric sclera | |||
=== | |||
===Abdomen=== | ===Abdomen=== | ||
*[[Abdominal distention]] | *[[Abdominal distention]] | ||
*[[Abdominal tenderness]] in the right | *[[Abdominal tenderness]] in the right upper abdominal quadrant | ||
*[[Rebound tenderness]] (positive Blumberg sign) | *[[Rebound tenderness]] (positive Blumberg sign) | ||
*A palpable abdominal mass in the right | *A palpable abdominal mass in the right upper abdominal quadrant | ||
*Guarding may be present | *Guarding may be present | ||
==References== | ==References== | ||
Revision as of 14:52, 30 November 2017
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Gallstone disease Microchapters |
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Treatment |
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Gallstone disease physical examination On the Web |
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American Roentgen Ray Society Images of Gallstone disease physical examination |
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Risk calculators and risk factors for Gallstone disease physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Patients with gallstones are usually not ill-appearing and don't have fever or tachycardia. Physical examination of patients with gallstones is sometimes remarkable for right upper quadrant pain, epigastric tenderness, guarding and jaundice. This occurs when stone reach more than 8mm in size. Courvoisier's sign (a palpable gallbladder on physical examination) may be palpated when the common bile duct becomes obstructed and the gallbladder becomes dilated. This mostly occurs with malignant common bile duct obstruction, but has been reported with choledocholithiasis[1]
Physical Examination
Gallstones are usually asymptomatic. This means that gallstones are discovered incidentally when imaging studies are obtained for another reason. However, if a stone were to block the common bile duct, this could lead to the development of biliary colic up to obstructive jaundice, where physical findings become relevant. [2]
Appearance of the Patient
- Patients with galstones usually appear to be well, unless a complication such as biliary colic or obstructive jaundice develops.
Vital Signs
- Fever
- Tachycardia with regular pulse
Skin
HEENT
- Icteric sclera
Abdomen
- Abdominal distention
- Abdominal tenderness in the right upper abdominal quadrant
- Rebound tenderness (positive Blumberg sign)
- A palpable abdominal mass in the right upper abdominal quadrant
- Guarding may be present
References
- ↑ Yang MH, Chen TH, Wang SE, Tsai YF, Su CH, Wu CW, Lui WY, Shyr YM (2008). "Biochemical predictors for absence of common bile duct stones in patients undergoing laparoscopic cholecystectomy". Surg Endosc. 22 (7): 1620–4. doi:10.1007/s00464-007-9665-2. PMID 18000708.
- ↑ Fitzgerald JE, White MJ, Lobo DN (2009). "Courvoisier's gallbladder: law or sign?". World J Surg. 33 (4): 886–91. doi:10.1007/s00268-008-9908-y. PMID 19190960.
- ↑ 3.0 3.1 "Jaundice - Wikipedia".
