Biliary colic

Abdomen | Gastroenterology | Biliary colic (Disease)


Biliary colic is pain associated with irritation of the viscera secondary to cholecystitis and gallstones.

Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones may be as small as a grain of sand or as large as a golf ball. There are two main types of gallstones: stones made of cholesterol, which are by far the most common type (cholesterol gallstones have nothing to do with cholesterol levels in the blood) and stones made of bilirubin, which can occur when red blood cells are being destroyed. This leads to too much bilirubin in the bile. These stones are called pigment stones.

Symptoms that may occur include: pain in the right upper or middle upper abdomen, fever, yellowing of skin and whites of the eyes (jaundice), clay-colored stools, nausea and vomiting. Rarely, a gallstone can become impacted in the ileocecal valve that joins the mecum and the ileum, causing gallstone ileums.

Causes and Risk factors

It’s a severe pain in the upper right quadrant of the abdomen that is usually caused by the gallbladder’s attempts to expel gallstones or by the movement of a stone in the bile ducts. Unlike renal colic, the phrase biliary colic refers to the actual cholelithiasis.

The following also make you more likely to develop gallstones: bone marrow or solid organ transplant; diabetes; failure of the gallbladder to empty bile properly; liver cirrhosis and biliary tract infections; chronic hemolytic anemia, including sickle cell anemia; rapid weight loss from eating a very low-calorie diet, or after bariatric surgery and intravenous feedings.

Diagnosis and Treatment

Tests undertaken include: abdominal ultrasound, abdominal CT scan, endoscope ultrasound. Pain management is an important part of treating biliary colic.

Treatment is dictated by the underlying cause. The presence of gallstones, usually visualized by ultrasound, generally necessitates a surgical treatment. ...

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