Chronic cholecystitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Chronic cholecystitis Microchapters
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Differentiating Cholecystitis from other Diseases
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Overview

Cholecystitis is usually diagnosed by a history of the symptoms, as well as examination findings like fever (usually low grade in uncomplicated cases) and a tender right upper quadrant +/- Murphy's sign. Subsequent laboratory and imaging tests are used to confirm the diagnosis and exclude other possible causes.

Physical Examination

Appearance of the Patient

• Patient may look toxic and in diffuse pain.

Vital Signs

• Heart rate - increased due to fever
• Temperature - raised
• Pulse - increased in rate, normal volume and rhythm. Volume may be decreased in cases of shock.
• Respiratory rate - within normal limits

Skin

• It may be dry in cases of hypovolemia (burns).
• Yellowish discoloration may be noticed if severe jaundice is present.

Eyes

• Jaundice may be noticed.

Abdomen

• Tenderness is observed over the right upper quadrant of the abdomen.
• Murphy's sign can be elicited.
• Gallbladder may be palpable.
• Fullness of right upper quadrant.
• In chronic cholecystitis, the gallbladder may not be palpable due to fibrosis and shrinking of the gallbladder.

References

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