Chronic cholecystitis physical examination: Difference between revisions
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* Patient may look toxic and in diffuse pain. | * Patient may look toxic and in diffuse pain. | ||
===Vital Signs=== | ===Vital Signs=== | ||
* Heart rate - increased due to fever | * [[Heart rate]] - increased due to [[fever]] | ||
* | * Temperature - raised | ||
* Pulse - increased in rate, normal volume and rhythm. Volume may be decreased in cases of shock. | * [[Pulse]] - increased in rate, normal volume and rhythm. Volume may be decreased in cases of [[shock]]. | ||
* Respiratory rate - within normal limits | * [[Respiratory rate]] - within normal limits | ||
===Skin=== | ===Skin=== | ||
* It may be dry in cases of hypovolemia( burns). | * It may be dry in cases of [[hypovolemia]] (burns). | ||
* Yellowish discoloration may be noticed if severe jaundice is present. | * Yellowish discoloration may be noticed if severe [[jaundice]] is present. | ||
===Eyes=== | ===Eyes=== | ||
* Jaundice may be noticed. | * Jaundice may be noticed. | ||
===Abdomen=== | ===Abdomen=== | ||
* Tenderness is observed over the right upper quadrant of the abdomen. | * Tenderness is observed over the right upper quadrant of the abdomen. | ||
* Murphy's sign can be elicited. | * [[Murphy's sign]] can be elicited. | ||
* Gallbladder may be palpable. | * [[Gallbladder]] may be palpable. | ||
* Fullness of right upper quadrant. | * Fullness of right upper quadrant. | ||
* In chronic cholecystitis | * In chronic cholecystitis, the gallbladder may not be palpable due to [[fibrosis]] and shrinking of the gallbladder. | ||
==References== | ==References== | ||
Revision as of 13:45, 15 February 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
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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.