Gallstone disease differential diagnosis: Difference between revisions
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Gallstone disease can manifest in a variety of clinical forms. The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. Studies have shown evidence that patients who present with biliary colic are more likely to have gallstones detected on imaging. <ref name="pmid7638565">{{cite journal |vauthors=Kraag N, Thijs C, Knipschild P |title=Dyspepsia--how noisy are gallstones? A meta-analysis of epidemiologic studies of biliary pain, dyspeptic symptoms, and food intolerance |journal=Scand. J. Gastroenterol. |volume=30 |issue=5 |pages=411–21 |year=1995 |pmid=7638565 |doi= |url=}}</ref> | Gallstone disease can manifest in a variety of clinical forms. The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. Studies have shown evidence that patients who present with biliary colic are more likely to have gallstones detected on imaging. <ref name="pmid7638565">{{cite journal |vauthors=Kraag N, Thijs C, Knipschild P |title=Dyspepsia--how noisy are gallstones? A meta-analysis of epidemiologic studies of biliary pain, dyspeptic symptoms, and food intolerance |journal=Scand. J. Gastroenterol. |volume=30 |issue=5 |pages=411–21 |year=1995 |pmid=7638565 |doi= |url=}}</ref> | ||
'''However, it is important to note that biliary colic can be concomitant in patients with other biliary disorders such as [[Cholecystitis|acute cholecystitis]], [[choledocholithiasis]], [[sphincter of Oddi dysfunction]], and functional gallbladder disorder.'''<ref name="pmid16844493">{{cite journal |vauthors=Portincasa P, Moschetta A, Palasciano G |title=Cholesterol gallstone disease |journal=Lancet |volume=368 |issue=9531 |pages=230–9 |year=2006 |pmid=16844493 |doi=10.1016/S0140-6736(06)69044-2 |url=}}</ref><ref name="pmid19524793">{{cite journal |vauthors=Center SA |title=Diseases of the gallbladder and biliary tree |journal=Vet. Clin. North Am. Small Anim. Pract. |volume=39 |issue=3 |pages=543–98 |year=2009 |pmid=19524793 |doi=10.1016/j.cvsm.2009.01.004 |url=}}</ref> | '''However, it is important to note that biliary colic can be concomitant in patients with other biliary disorders such as [[Cholecystitis|acute cholecystitis]], [[choledocholithiasis]], [[sphincter of Oddi dysfunction]], and functional gallbladder disorder.'''<ref name="pmid16844493">{{cite journal |vauthors=Portincasa P, Moschetta A, Palasciano G |title=Cholesterol gallstone disease |journal=Lancet |volume=368 |issue=9531 |pages=230–9 |year=2006 |pmid=16844493 |doi=10.1016/S0140-6736(06)69044-2 |url=}}</ref><ref name="pmid19524793">{{cite journal |vauthors=Center SA |title=Diseases of the gallbladder and biliary tree |journal=Vet. Clin. North Am. Small Anim. Pract. |volume=39 |issue=3 |pages=543–98 |year=2009 |pmid=19524793 |doi=10.1016/j.cvsm.2009.01.004 |url=}}</ref> | ||
==Differential diagnosis== | ==Differential diagnosis== | ||
The differential diagnosis of diseases presenting with abdominal pain, fever and jaundice is discussed below. | The differential diagnosis of diseases presenting with abdominal pain, fever and jaundice is discussed below. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Gallstone disease must be differentiated from other diseases that cause right upper quadrant pain such as: gastroesophageal reflux disorder, peptic ulcer disease,hepatitis,sphincter of Oddi dysfunction,appendicitis, bile duct stricture, chronic pancreatitis, irritable bowel syndrome, ischemic heart disease, pyelonephritis, ureteral calculi and complications of gallstone disease include: acute cholecystitis, choledocholithiasis, acute pancreatitis, and acute cholangitis.
Differentiating Gallstone disease from other Diseases
Gallstone disease can manifest in a variety of clinical forms. The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. Studies have shown evidence that patients who present with biliary colic are more likely to have gallstones detected on imaging. [1] However, it is important to note that biliary colic can be concomitant in patients with other biliary disorders such as acute cholecystitis, choledocholithiasis, sphincter of Oddi dysfunction, and functional gallbladder disorder.[2][3]
Differential diagnosis
The differential diagnosis of diseases presenting with abdominal pain, fever and jaundice is discussed below. Abbreviations: RUQ= Right upper quadrant of the abdomen, LUQ= Left upper quadrant, LLQ= Left lower quadrant, RLQ= Right lower quadrant, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, IV= Intravenous, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CXR= Chest X ray, IgA= Immunoglobulin A, IgG= Immunoglobulin G, IgM= Immunoglobulin M, CT= Computed tomography, PMN= Polymorphonuclear cells, ESR= Erythrocyte sedimentation rate, CRP= C-reactive protein, TS= Transferrin saturation, SF= Serum Ferritin, SMA= Superior mesenteric artery, SMV= Superior mesenteric vein, ECG= Electrocardiogram
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References
- ↑ Kraag N, Thijs C, Knipschild P (1995). "Dyspepsia--how noisy are gallstones? A meta-analysis of epidemiologic studies of biliary pain, dyspeptic symptoms, and food intolerance". Scand. J. Gastroenterol. 30 (5): 411–21. PMID 7638565.
- ↑ Portincasa P, Moschetta A, Palasciano G (2006). "Cholesterol gallstone disease". Lancet. 368 (9531): 230–9. doi:10.1016/S0140-6736(06)69044-2. PMID 16844493.
- ↑ Center SA (2009). "Diseases of the gallbladder and biliary tree". Vet. Clin. North Am. Small Anim. Pract. 39 (3): 543–98. doi:10.1016/j.cvsm.2009.01.004. PMID 19524793.