Gallbladder Disease
Pathology: A condition, in which the gall bladder becomes inflamed, infected, obstructed or contains gall stones. The most common form of gall bladder disease is gall stones (NIH, 2009).
Demographics (NIH, 2010; Shaffer et al., 2006; Williams, 2008): Women are more commonly affected than males due hormonal levels. Gallbladder disease is also associated with increased age, Mexican Americans, American Indians, increased intake of foods high in fat resulting in increased cholesterol levels.
Clinical Presentation (NIH, 2010; Shaffer et al. 2006): Right upper abdominal pain, jaundice, low-grade fever, chills, indigestion, feelings of fullness, scleral icterus, excessive belching or flatulence, intolerance of fatty foods, persistent pruritis, pain in the mid-epigastrium with referral to back and right shoulder and anterior rib pain (tip of 10th rib, along with ribs 11 and 12), fatigue and weight loss.
Differential Diagnosis (Goodman & Snyder, 2007): A thorough patient history, with focus on reviewing all red flags and constitutional signs and symptoms to check for systemic illness. Interview should also include food intake; types of food and their relation to the signs and symptoms. Examination should also include palpation of the upper right quadrant, test for asterixsis (flapping tremors). Positional movements should also be checked as pain will not alleviate with change in postures as pain of musculoskeletal origin will subside.
Bottom Line: Refer out
This condition is immediate physician referral. The physician will then order blood work and ultrasound to determine the cause of the gallbladder disease and develop a plan of care for treatment (Goodman & Synder, 2007).
Demographics (NIH, 2010; Shaffer et al., 2006; Williams, 2008): Women are more commonly affected than males due hormonal levels. Gallbladder disease is also associated with increased age, Mexican Americans, American Indians, increased intake of foods high in fat resulting in increased cholesterol levels.
Clinical Presentation (NIH, 2010; Shaffer et al. 2006): Right upper abdominal pain, jaundice, low-grade fever, chills, indigestion, feelings of fullness, scleral icterus, excessive belching or flatulence, intolerance of fatty foods, persistent pruritis, pain in the mid-epigastrium with referral to back and right shoulder and anterior rib pain (tip of 10th rib, along with ribs 11 and 12), fatigue and weight loss.
Differential Diagnosis (Goodman & Snyder, 2007): A thorough patient history, with focus on reviewing all red flags and constitutional signs and symptoms to check for systemic illness. Interview should also include food intake; types of food and their relation to the signs and symptoms. Examination should also include palpation of the upper right quadrant, test for asterixsis (flapping tremors). Positional movements should also be checked as pain will not alleviate with change in postures as pain of musculoskeletal origin will subside.
Bottom Line: Refer out
This condition is immediate physician referral. The physician will then order blood work and ultrasound to determine the cause of the gallbladder disease and develop a plan of care for treatment (Goodman & Synder, 2007).