<unk>  presents chiefly with abdominal pain located in the right upper abdomen. This pain is described as biliary colic. Pain typically occurs suddenly and radiates to the right shoulder and back, depending on several factors, including specific diseases. It can either be constant or episodic and last from minutes to hours. This pain is described as biliary colic pain. Other common symptoms with<unk>  and biliary colic are nausea and vomiting. With conditions such as cholecystitis and choledocholithiasis, fever may be present. During the physical examination, the patient will present with Murphy's sign. This maneuver requires the physician to grab the lower part of the right ribs and curl their fingers under them. A positive test elicits pain with deep inspiration and is indicative of inflammation of the gallbladder, cholecystitis. With positive Murphy's sign, deep palpation of the abdomen also elicits pain. In these cases, physicians will need to rule out peritonitis, inflammation of the abdominal cavity. A negative Murphy's sign does not rule out all<unk> s as ascending cholangitis. Using an ultrasound transducer supplanting a physician's hands during an abdominal ultrasound can detect a positive Murphy's sign. The sign also has over a 90% positive and negative predictive value for acute cholecystitis Gallstones Gallstones may develop in the gallbladder as well as elsewhere in the biliary tract. If gallstones in the gallbladder are symptomatic, surgical removal of the gallbladder, known as cholecystectomy may be indicated. Gallstones form when the tenuous balance of solubility of biliary lipids tips in favor of precipitation of cholesterol, unconjugated bilirubin, or bacterial degradation products of biliary lipids. For cholesterol gallstones, metabolic alterations in hepatic cholesterol secretion combine with changes in gallbladder motility and intestinal bacterial degradation of bile salts to destabilize cholesterol carriers in bile and produce cholesterol crystals. For black pigment gallstones, changes in heme metabolism or bilirubin absorption lead to increased bilirubin concentrations and precipitation of calcium bilirubinate. In contrast, mechanical obstruction of the biliary tract is the major factor leading to bacterial degradation and precipitation of biliary lipids in brown pigment stones.
Gallbladder disease
Hepatolithiasis
Gallbladder cancer
Biliary disease
Common bile duct stone
Biliary colic
Biliary reflux
Liver cancer