Biliary Colic

A condition when gallstones become impacted in the cystic duct of the gallbladder and cause pain when the gallbladder contracts and attempts to push the stones through. 

Demographics: Gallstones are more common in the Western population and are found in about 20% of women compared to 8% of men.  High oestrogen and obesity increase the risk.

Clinical Presentation:
Signs and Symptoms
  • Right upper quadrant pain
  • Tenderness over the gallbladder
  • GI symptoms
  • Nausea
  • Vomiting
  • Radiating pain into the right shoulder and between the sacapulae

Differential Diagnosis: Any patient that has mid-back, scapular, and right shoulder pain without a history of trauma should be screened for potential systemic origin. 

Bottom Line: Refer out
A patient that presents with the signs and symptoms above should see their physician for further testing (Mackay and Dillane 2004).

References:
Please refer to the "Biliary Colic" section of the reference list.