Last reviewed: February 2020
Last updated: January  2020

Summary

Definition

History and exam

Key diagnostic factors

  • previous episode of biliary pain
  • right upper quadrant (RUQ) pain
  • positive Murphy sign
  • abdominal mass

Other diagnostic factors

  • right shoulder pain
  • anorexia
  • nausea
  • fever
  • vomiting
  • jaundice

Risk factors

  • gallstones
  • physical inactivity
  • low fiber intake
  • severe illness
  • trauma
  • severe burns
  • total parenteral nutrition (TPN)
  • diabetes
  • ceftriaxone
  • cyclosporine
  • hepatic arterial embolization
  • infections

Diagnostic investigations

1st investigations to order

  • CBC
  • C-reactive protein
  • LFTs
  • right upper quadrant (RUQ) ultrasound scan
More 1st investigations to order

Investigations to consider

  • cholescintigraphy (hepatobiliary iminodiacetic acid [HIDA] scan)
  • abdominal CT
  • abdominal MRI
  • abdominal x-ray
More investigations to consider

Treatment algorithm

Contributors

Professor of Surgery

University of New Mexico

School of Medicine

Albuquerque

NM

Disclosures

CB is an author of one study referenced in this topic. CB declares that he has no other competing interests.

Peer reviewersVIEW ALL

Professor of Pediatrics

Chief

Division of Gastroenterology, Hepatology, and Nutrition

University of Chicago Comer Children's Hospital

Chicago

IL

Disclosures

SG declares that he has no competing interests.

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