Physical Examination

General Appearance: Obese, restless patient unable to find a comfortable position. Signs of dehydration, septic appearance. Note whether the patient appears ill, well, or malnourished.

Vital Signs: Pulse (mild tachycardia), temperature (low-grade fever), respiratory rate (shallow respirations), BP.

Skin: Jaundice, capillary refill.

HEENT: Scleral icterus, sublingual jaundice.

Abdomen: Epigastric or right upper quadrant tenderness, Murphy's sign (tenderness and inspiratory arrest during palpation of RUQ); firm tender, sausage-like mass in RUQ (enlarged gallbladder); guarding, rigidity, rebound (peritoneal signs); Charcot's sign (intermittent right upper quadrant abdominal pain, jaundice, fever).

Labs: Ultrasound, HIDA (radionuclide) scan, WBC, hyperbilirubinemia, alkaline phosphatase, AST, amy-lase.

Plain Abdominal X-ray: Increased gallbladder shadow, gallbladder calcifications; air in gallbladder wall (emphysematous cholecystitis), small bowel obstruction (gallstone ileus).

Differential Diagnosis: Calculus cholecystitis, cholangitis, peptic ulcer, pancreatitis, appendicitis, gastroesophageal reflux disease, hepatitis, nephrolithiasis, pyelonephritis, hepatic metastases, gonococcal perihepatitis (Fitz-Hugh-Curtis syndrome), pleurisy, pneumonia, angina, herpes zoster.

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Get Rid of Gallstones Naturally

Get Rid of Gallstones Naturally

One of the main home remedies that you need to follow to prevent gallstones is a healthy lifestyle. You need to maintain a healthy body weight to prevent gallstones. The following are the best home remedies that will help you to treat and prevent gallstones.

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