GALLSTONES

Biliary Colic

Small hard masses formed in the gallbladder or biliary tree.

Risk factors

  • Age, gender, family history
  • Obesity, diabetes, use of oral contraceptives, dyslipidemia

Clinical features

  • Asymptomatic and often found by chance at an abdominal ultrasound
  • Biliary colic: episodes of intense acute epigastric right hypocondrial pain (due to acute temporary blockage of a
    bile duct) lasting few minutes to few hours, often triggered by a high-fat meal. It can occur sporadically. NO fever or jaundice are present.
  • Cholecystitis or cholangitis due to blockage and infection of bile
  • Pancreatitis due to blockage of the pancreatic duct

Differential diagnosis

  • Peptic ulcer disease

Investigations

  • Abdominal ultrasound
  • Liver function tests

Management

Asymptomatic

  • Does not require any intervention

Biliary colic

  • Diclofenac 75 mg IM and/or
  • Pethidine 50-100 mg IM
  • Low-fat diet
  • Refer for cholecystectomy after acute phase