Overview

• Inflammation of the gall bladder, usually due to cystic duct obstruction by a gallstone
• F>M, >50 yrs old
• Risk Factors → Gallstones (90% of patients), TPN (fasting = gallbladder hypomotility & stasis), Diabetes

Making Diagnosis

Clinical Features:

• Pain & Tenderness in RUQ
• Signs of Inflammation (Fever)
• Palpable Mass → distended, tender gallbladder
• Right Shoulder Pain, Nausea, Anorexia
• Positive Murphy Sign → sudden pause during inspiration upon deep palpation of RUQ due to pain

Investigations:

• Abdominal Ultrasound → if sepsis not suspected. Thick gallbladder wall.
  • CT or MRI of Abdomen → if sepsis suspected
• FBC → increased WCC and CRP
• Normal LFT’s