Last reviewed: 6 Feb 2021
Last updated: 03 Nov 2020
Summary
Definition
History and exam
Key diagnostic factors
- previous episode of biliary pain
- right upper quadrant 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 ultrasound scan
Investigations to consider
- cholescintigraphy (hepatobiliary iminodiacetic acid [HIDA] scan)
- abdominal CT
- abdominal MRI
- abdominal x-ray
Treatment algorithm
Contributors
Authors
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 reviewers
Consultant Surgeon
HPB Surgery Unit
The Royal London Hospital
London
UK
Disclosures
SB declares that he has no competing interests.
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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