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Diagnosis

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Gallstone Disease and its Management

Abstract

A diagnosis of gallstones may be made in a variety of clinical settings, some specifically related to gallstone disease or its consequences, some commonly considered to be related but on analysis found to be non-specific and others where gallstones are discovered incidentally. The logical application of diagnostic tools for the documentation of gallstone disease naturally depends upon the correct recognition of clinical presentations. Single or recurrent attacks of classical biliary pain, often mistakenly referred to as ‘colic’, acute cholecystitis, empyema and mucocoele of the gallbladder, extrahepatic biliary obstruction causing cholestasis, bacterial cholangitis, and single or recurrent attacks of acute pancreatitis may all be specific effects of gallstones within the gallbladder or bile ducts and are the clinical problems discussed later. The non-specific complaints of dyspepsia, dietary fat intolerance, flatulence, upper abdominal bloating, postprandial fullness, heartburn, nausea, vomiting and vague abdominal pains or discomfort are common to a wide variety of upper and lower gastrointestinal conditions and the finding of gallstones in patients with these symptoms may be coincidental. The differential diagnosis for this group of symptoms with or without abdominal signs is well known1 but it is increasingly apparent from experience of investigating many mainly young and middle-aged females with ‘biliary’ symptoms that the ‘right upper quadrant’ or ‘hepatic flexure syndrome’ variant of irritable bowel syndrome accounts for many more cases of right hypochondrial pain than do gallstones.

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  1. D. L. Carr-Locke
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  1. General Hospital, Bishop Auckland, UK

    Malcolm C. Bateson (Consultant Physician and Specialist in Gastroenterology) (Consultant Physician and Specialist in Gastroenterology)

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Carr-Locke, D.L. (1986). Diagnosis. In: Bateson, M.C. (eds) Gallstone Disease and its Management. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-4173-1_4

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  • DOI: https://doi.org/10.1007/978-94-009-4173-1_4

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