Symptomatic cholelithiasis: Difference between revisions
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===Diagnosis=== | ===Diagnosis=== | ||
# History | #History | ||
## RUQ pain that is | ##RUQ pain that is constant, lasts 1-5hr, and then remits | ||
## Usually does not occur during fasting | ###Pain >5hr suggests cholecystitis, cholangitis, or pancreatitis | ||
# Physical Exam | ##Usually does not occur during fasting | ||
## Often benign; as compared to cholecystitis, usually negative Murphy's Sign | #Physical Exam | ||
# Labs | ##Often benign; as compared to cholecystitis, usually negative Murphy's Sign | ||
## LFT, CBC normal | #Labs | ||
# Ultrasound | ##LFT, CBC normal | ||
## Sensitivity 84%, Specificity 99% | #Ultrasound | ||
##Sensitivity 84%, Specificity 99% | |||
===Treatment=== | ===Treatment=== | ||
# IV/IM Ketorolac (as effective as meperidine) with Rx for Ibuprofen | #IV/IM Ketorolac (as effective as meperidine) with Rx for Ibuprofen | ||
==Source== | |||
*UpToDate | |||
*Tintinalli | |||
==See Also== | ==See Also== | ||
Revision as of 04:13, 1 August 2011
Diagnosis
- History
- RUQ pain that is constant, lasts 1-5hr, and then remits
- Pain >5hr suggests cholecystitis, cholangitis, or pancreatitis
- Usually does not occur during fasting
- RUQ pain that is constant, lasts 1-5hr, and then remits
- Physical Exam
- Often benign; as compared to cholecystitis, usually negative Murphy's Sign
- Labs
- LFT, CBC normal
- Ultrasound
- Sensitivity 84%, Specificity 99%
Treatment
- IV/IM Ketorolac (as effective as meperidine) with Rx for Ibuprofen
Source
- UpToDate
- Tintinalli