Gallbladder Pain (Gall Bladder Pain) (cont.)
Charles Patrick Davis, MD, PhD
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Bhupinder Anand, MD
In this Article
How is the cause of gallbladder pain diagnosed?
The history and physical exam helps to establish a presumptive diagnosis. Murphy's sign (pain or temporary respiratory arrest on deep right subcostal palpation) has been estimated to be over 95% specific for acute cholecystitis. A few laboratory tests such as liver function tests, lipase, amylase, complete blood count (CBC), and an abdominal X-ray are done to determine the exact problem is causing the pain. Ultrasound can detect gallstones, and CT scan may delineate organ structural changes. A HIDA scan (uses radioactive material) can measure gallbladder emptying while an ERCP test uses an endoscope to place dye in the ducts of the pancreas, gallbladder and liver. Magnetic resonance imaging (MRI) is sometimes used to detail the organ structures (liver, gallbladder, and pancreas). The results of these tests help pinpoint the problem and establish the diagnosis.
What is the treatment of gallbladder pain?
If you have no gallbladder pain (even if you have gallstones but never had pain), you need no treatment. Some patients who have had one or two attacks may elect to avoid treatment. Pain during an acute attack is often treated with morphine. The definitive treatment is to remove the gallbladder (and/or the obstructing gallstones) by surgery. Currently, the surgical method of choice is laparoscopic surgery, where the gallbladder is removed by instruments using only small incisions in the abdomen. However, some patients may require more extensive surgery. Usually, people do well once the gallbladder is removed.
Women who are pregnant are treated like women who are not pregnant, although pregnancy is a risk factor for cholesterol gallstone development. Although supportive care is tried in women who are pregnant, acute cholecystitis is the second most common surgical emergency in pregnancy (appendicitis is the first).
Medically Reviewed by a Doctor on 2/4/2015
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