Acute cholecystitis physical examination: Difference between revisions
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===HEENT=== | ===HEENT=== | ||
There is no abnormality on HEENT examination. | |||
===Neck=== | ===Neck=== | ||
There is no abnormality on neck examination. | |||
===Lungs=== | ===Lungs=== | ||
Normal Vesicular [[breath sounds]]. | |||
===Heart=== | ===Heart=== | ||
S1 and S2 normal, no [[Murmurs|murmur]]/rubs/[[Gallop rhythm|gallops]] | |||
===Abdomen=== | ===Abdomen=== | ||
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===Back=== | ===Back=== | ||
There is no abnormality on back examination. | |||
===Genitourinary=== | ===Genitourinary=== | ||
There is no abnormality on genitourinary examination. | |||
===Neuromuscular=== | ===Neuromuscular=== | ||
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===Extremities=== | ===Extremities=== | ||
There is no abnormality on extremities examination. | |||
==References== | ==References== | ||
Revision as of 19:38, 13 December 2017
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Risk calculators and risk factors for Acute cholecystitis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
Patients with acute cholecystitis usually appear ill.Physical examination of patients with acute cholecystitis is usually remarkable for right upper quadrant abdominal tenderness, positive murphy's sign, and fever.
The presence of murphy's sign on physical examination is highly suggestive of acute cholecystitis.
Physical Examination
- The presence of positive murphy's sign on physical examination is highly suggestive of acute cholecysitis.[1][2]
Appearance of the Patient
- Ill appearing
- In severe distress
Vital Signs
- High-grade fever [3][4]
- Tachycardia with regular pulse.
- Tachypnea
Skin
-
Description (Adapted from Dermatology Atlas)
-
Description (Adapted from Dermatology Atlas)
HEENT
There is no abnormality on HEENT examination.
Neck
There is no abnormality on neck examination.
Lungs
Normal Vesicular breath sounds.
Heart
S1 and S2 normal, no murmur/rubs/gallops
Abdomen
- Abdominal tenderness in the right upper abdominal quadrant.
- Rebound tenderness[5]
- A palpable gall bladder,positive Courvoisier's sign.[6]
- Voluntary and involuntary guarding may be present.[7]
- Murphy test positive.[8]
Back
There is no abnormality on back examination.
Genitourinary
There is no abnormality on genitourinary examination.
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Altered mental status can be observed in some patients.
Extremities
There is no abnormality on extremities examination.
References
- ↑ Adedeji OA, McAdam WA (1996). "Murphy's sign, acute cholecystitis and elderly people". J R Coll Surg Edinb. 41 (2): 88–9. PMID 8632396.
- ↑ Diehl AK (1992). "Symptoms of gallstone disease". Baillieres Clin. Gastroenterol. 6 (4): 635–57. PMID 1486206.
- ↑ Singer AJ, McCracken G, Henry MC, Thode HC, Cabahug CJ (1996). "Correlation among clinical, laboratory, and hepatobiliary scanning findings in patients with suspected acute cholecystitis". Ann Emerg Med. 28 (3): 267–72. PMID 8780468.
- ↑ Cooper C (1997). "Acute cholecystitis". Ann Emerg Med. 29 (4): 554–5. PMID 9095024.
- ↑ Strasberg SM (2008). "Clinical practice. Acute calculous cholecystitis". N. Engl. J. Med. 358 (26): 2804–11. doi:10.1056/NEJMcp0800929. PMID 18579815.
- ↑ Fitzgerald JE, White MJ, Lobo DN (2009). "Courvoisier's gallbladder: law or sign?". World J Surg. 33 (4): 886–91. doi:10.1007/s00268-008-9908-y. PMID 19190960.
- ↑ Katabathina VS, Zafar AM, Suri R (2015). "Clinical Presentation, Imaging, and Management of Acute Cholecystitis". Tech Vasc Interv Radiol. 18 (4): 256–65. doi:10.1053/j.tvir.2015.07.009. PMID 26615166.
- ↑ Jain A, Mehta N, Secko M, Schechter J, Papanagnou D, Pandya S, Sinert R (2017). "History, Physical Examination, Laboratory Testing, and Emergency Department Ultrasonography for the Diagnosis of Acute Cholecystitis". Acad Emerg Med. 24 (3): 281–297. doi:10.1111/acem.13132. PMID 27862628.