Clinical features
Possible symptoms of cholecystitis include:
- pain in the right upper quadrant radiating to the right shoulder
- nausea
- vomiting
- fever
Possible signs include:
- tenderness over the right upper quadrant
- tenderness over the gallbladder that is demonstrable on inspiration
- Boas' sign (hyperaesthesia below the right hypochondrium or 12th rib region)
- gallbladder is usually impalpable
- jaundice only occurs in the minority of patients
- check for Murphy’s sign (where the examiner's hand rests along the costal margin and deep inspiration causes pain).
References
- Indar AA, Beckingham IJ. Acute cholecystitis. BMJ. 2002 Sep 21;325(7365):639-43.
- Yokoe M, Hata J, Takada T, et al. Tokyo guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):41-54.
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