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Key factors for diagnosis
- previous episode of biliary pain (high recurrence rate)
- RUQ pain. Usually intense lasting >30 minutes. May move (epigastrium to LUQ to RUQ. Most often after fatty meal.
- Positive Murphy's sign.
- Abdominal mass - palpable in 30-40% cases.
Other diagnostic factors
- Referred right shoulder pain
- Anorexia
- Nausea, especially with RUQ pain
- Fever, suggests more complicated disease (abscess, perforation)
- Vomiting, non-specific but often associated.
- Jaundice, uncommon, ~10% cases.
Risk Factors
Strong
- gallstones
- severe illness causing gallbladder dysmotility, gallbladder ischaemia and TPN.
- TPN - causing gallbladder stasis, biliary sludge and decreased emptying
Weak
- physical inactivity
- low fibre intake
- trauma
- severe burns
- ceftriaxone
- cyclosporin
- hepatic arterial embolisation
- infections
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