Male with Severe upper Abdominal pain

Monday, December 28, 2009
This is an Erect Abdominal Xray of a 52year male patient who has been compailning of Severe constant type right upper quadrant abdominal pain which was lasting for several hours.What abnormality you can see in this X-ray?

ANSWER - Gallstones in the Gallbladder

Gallstones are calculi formed in the gallbladder or bile duct. There are three main types of stone - pure cholesterol, pigment and the commonest, mixed stones.Only 20% are radio-opaque.
Women are affected twice as often as men; pregnancy, obesity and diabetes are important predisposing factors.
Majority of  people are asymptomatic.

INVESTIGATIONS
Plain abdominal x-ray
Ultrasound -the most common diagnostic test
Oral cholecystogram
Nuclear scanning - HIDA Scan
ERCP

Complications
Common complications include:  
  • flatulent dyspepsia
  • biliary colic
  • cholecystitis
  • cholangitis
  • obstructed neck of the gallbladder
  • mucocoele
  • extra-hepatic cholestasis
  • pancreatitis                                 
Rare complications include:
  • gall-stone ileus
  • gall-bladder perforation
  • gall-bladder carcinoma
 TREATMENT

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4 comments

  1. Zainab Akram Says:
  2. multiple small round radio-opaque shadows on the Rt. upper Q. area >>>Gall bladder stones.

     
  3. shameel Says:
  4. radio-opaque multiple areas in region of gall bladder.. definitely multiple gall stones..

     
  5. Bobbymurjani Says:
  6. the diagnose is cholcystitis acute with cholelithyasis multiple

     
  7. azhar Says:
  8. acute inflammation of GB due to Gall Stones. can obstruct CBD. so urgent Laproscopic Cholecystectomy is indicated.

     

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