Overview

• Biliary Colic → Pain resulting from obstruction of the gallbladder or common bile duct, usually by a stone
• Occurs due to contractions of the biliary tree in an attempt to relieve an obstruction (e.g. due to a stone)
• Risk factors of gallstones → Fair (Caucasian), Fat, Fertile, Forty, Female. Also OCP, rapid weight loss, SCA (haemolytic conditions = bilirubin breakdown).
  • Cholesterol Stones (80%) ⇒ composed of cholesterol and calcium carbonate
  • Pigment Stones ⇒ associated with haemolytic diseases such as SCA, composed of calcium bilirubinate
    • Due to increased unconjugated bilirubin
• Biliary Colic is most common presentation of gallstone disease

Making Diagnosis

Clinical Features:

• Colicky RUQ pain
  • Individuals may present with pain following ingestion of a fatty meal
• Nausea and vomiting
• Pain may radiate to the right scapula
• Murphy’s Sign Negative

Investigations:

• Ultrasound → thin gallbladder wall
  • MRCP → very sensitive. If ultrasound is negative but bile duct is dilated or abnormal LFTs.
• LFTs → ALP, ALT, Bilirubin

<aside> 💡 Biliary Colic ⇒ no fever and LFTs/inflammatory markers are normal

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