Biliary colic without acute cholecystitis
A 42 year old male, obese with a history of GERD presented to the clinic complaining of moderated abdominal pain in the right upper quadrant. The pain started after he consumed a large fatty meal. The pain radiated to his back. Denied fever, chest pain, diarrhea or any change in his bowel movements. Admitted vomiting. She took medications for the pain with proton pump inhibitors but did not relieved his pain. He consumes alcohol on the weekends. Quite smoke since 10 years ago. Physical examination is normal. Murphy’s sign was negative
Introduction
Should be a paragraph that provides a brief overview of the case and main diagnosis:
1-Biliary colic without cholecystitis:
:
Differential Diagnoses
Differential Diagnosis:
Provide EACH ( 3 of them) differential diagnosis with the rationale and supporting evidence with the REFERENCE for each one. Also explain why differentials (2&3) were not the primary diagnosis.
1- Biliary cholic without cholecystitis:
2- Acute cholecystitis:
2- Duodenal ulcer:
Diagnostics
1- Identify the lab, radiology, or other tests needed for the main diagnosis( Biliary cholic without cholecystitis): and the other 2 possible diagnosis provided ( Acute cholecystitis and Duodenal ulcer) with supporting evidence.
Sample Solution
A 42-year-old male with a history of GERD presented to the clinic complaining of moderate abdominal pain in the right upper quadrant. The pain started after he consumed a large fatty meal. The pain radiated to his back. He denied fever, chest pain, diarrhea, or any change in his bowel movements. He admitted to vomiting. He consumes alcohol on the weekends and quit smoking 10 years ago. Physical examination was normal. Murphy's sign was negative.
Differential Diagnoses
The differential diagnoses for this case include:
- Biliary colic without cholecystitis: This is the most likely diagnosis. It is caused by the passage of a gallstone through the bile duct. The pain is typically sudden and severe, and it is often located in the right upper quadrant. It can radiate to the back or shoulder. The pain may be accompanied by nausea and vomiting.
Full Answer Section
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- Acute cholecystitis: This is inflammation of the gallbladder. It is caused by a blockage of the bile duct, which can lead to infection. The pain is typically more severe than biliary colic, and it is often accompanied by fever, nausea, and vomiting.
- Duodenal ulcer: This is an ulcer in the lining of the duodenum, the first part of the small intestine. It is caused by the bacterium Helicobacter pylori. The pain is typically located in the upper abdomen, and it is often worse after eating. It can be accompanied by nausea and vomiting.
- Blood tests: These tests can be used to check for inflammation and infection.
- Ultrasound: This test can be used to visualize the gallbladder and bile ducts. It can be used to identify gallstones and inflammation of the gallbladder.
- CT scan: This test can also be used to visualize the gallbladder and bile ducts. It is more sensitive than ultrasound for detecting gallstones.
- Endoscopic ultrasound: This test involves inserting a small ultrasound probe into the stomach. It is the most sensitive test for detecting gallstones.
- Biliary colic without cholecystitis: This condition is usually treated with pain medication and fluids. If the pain is severe, a cholecystectomy (removal of the gallbladder) may be necessary.
- Acute cholecystitis: This condition is usually treated with antibiotics and pain medication. A cholecystectomy may be necessary if the condition does not improve with medical treatment.
- Duodenal ulcer: This condition is usually treated with antibiotics and acid-suppressing medications. If the ulcer does not heal with medical treatment, surgery may be necessary.