Gallstone disease differential diagnosis: Difference between revisions
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* The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. | * The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. | ||
* 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> | * 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. | ||
<span style="font-size:85%">'''Abbreviations:''' | <span style="font-size:85%">'''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]]</span> | '''[[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'''= [[Antimitochondrial antibodies|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]]</span> | ||
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To review a differential diagnosis for abdominal pain, [[Abdominal pain differential diagnosis|click here]] | To review a differential diagnosis for abdominal pain, [[Abdominal pain differential diagnosis|click here]] | ||
Revision as of 15:25, 15 December 2017
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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 including 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.
- 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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To review a differential diagnosis for abdominal pain, click here
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.