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]
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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
- Temperture - 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 gall bladder may not be palpable due to fibrosis and shrinking of gallbladder.