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(Created page with "'''Acute calculous cholecystitis''' is one manifestation of complicated gallstone disease characterised by inflammation of the gallbladder secondary to cystic duct obstruction by a gallstone. It's not necessarily infected by bacteria, but it may be. Acute calculous cholecystitis may be complicated by gallbladder gangrene, perforation, or emphysema. == Clinical features == Cholecystitis usually presents with right upper quadrant pain which lasts longer than biliary...") |
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== Clinical features == | == Clinical features == | ||
Cholecystitis usually presents with right upper quadrant pain which lasts longer than biliary colic, fever, nausea/vomiting, and positive Murphy sign (may be negative in elderly). The patient usually appears ill and may have abnormal vital signs. | Cholecystitis usually presents with right upper quadrant pain which lasts longer than biliary colic, fever, nausea/vomiting, and positive Murphy sign (may be negative in elderly). The patient usually appears ill and may have abnormal vital signs. | ||
Murphy sign refers to the patient abruptly stopping a deep inspiration during palpation of the upper right quadrant due to sudden pain. This occurs because during inspiration, the tender gallbladder is pushed caudally by the expanding lungs, eventually hitting the palpating hand. Note that Murphy sign is not sensitive in elderly. | |||
== Diagnosis and evaluation == | == Diagnosis and evaluation == |