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Background
Anatomy & Pathophysiology
- Gallstones are classified as cholesterol stones and pigmented stones (black and brown), and are present in approx 20% of females and 8% of males in the United States
- These stones cause the majority of all biliary tract problems, and depending on where the stone become impacted, specific problems occur.
- Bile flows out the gallbladder, down the cystic duct into the common bile duct, and ultimately into the 1st portion of the duodenum.
Gallbladder anatomy (overview).
Clinical Features
History
- RUQ pain that is constant, lasts 1-5hr, and then remits
- Usually does not occur during fasting
- Radiation to the right shoulder increases likelihood, but is not sensitive
Physical Exam
- Often benign; as compared to cholecystitis, usually negative Murphy's Sign
Differential Diagnosis
Evaluation
Gallstones found incidentally on
KUB (xrays are not sensitive).
Management
Disposition
See Also
References