LecciónDOLOR EN HIPOCONDRIO DERECHO sin título

Rodolfo A. Cabrales Vega

Profesor Titular

Programa de Medicina

Universidad Tecnológica de Pereira

Open Ended

What is the most likely diagnosis?

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What are the differences between

Symptomatic Cholelitiasis (biliary colic)

 and Acute Cholecystitis?

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Why is it important to distinguish between symptomatic cholelithiasis and acute cholecystitis?

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What is the differential diagnosis?

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What exactly causes acute cholecystitis

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What is chronic cholecystitis?

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What are the different manifestations of gallstone disease?

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What is the next step in the work-up? What are the specific findings

that would confirm the diagnosis?

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Why should liver tests, amylase and lipase always be sent

in the presence of Right Upper Quadrant and Epigastric pain?

What is the significance of abnormalities?

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What is the next step in the management?

1. Acute cholecystitis is one of the most common reasons for hospital
admission with acute abdominal pain.

2. Approximately 90–95% of acute cholecystitis is related to gallstones,
with 5–10% of cases due to acalculous disease.

3. Ultrasound is more useful than CT and MRI for the initial evaluation of
acute biliary disease.

4. CT is arguably the best technique for imaging of complicated gallbladder
disease, particularly for direct imaging of emphysematous cholecystitis,
gallstone ileus, and confirmation of suspected gallbladder perforation.