Acute Cholecystitis: Physical Examination
The physical examination may reveal fever, tachycardia, and tenderness in the RUQ or epigastric region, often with guarding or rebound.
Murphy sign, which is specific but not sensitive for cholecystitis, is described as tenderness and an inspiratory pause elicited during palpation of the RUQ. |
EtiologyPathophysiologyHistoryPhysical ExaminationInvestigationsDifferential DiagnosisManagementClinical ScenariosAnswers |
A palpable gallbladder or fullness of the RUQ is present in 30-40% of cases. Jaundice may be noted in approximately 15% of patients.
The absence of physical findings does not rule out the diagnosis of cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ.
Elderly patients and patients with diabetes frequently have atypical presentations, including absence of fever and localized tenderness with only vague symptoms.
The absence of physical findings does not rule out the diagnosis of cholecystitis. Many patients present with diffuse epigastric pain without localization to the RUQ.
Elderly patients and patients with diabetes frequently have atypical presentations, including absence of fever and localized tenderness with only vague symptoms.