Biliary Colic

Question 1

What occurs in biliary colic?
When is the pain associated with biliary colic worse?
What is a mucocele and why does it form in relation to biliary colic?

Answer 1

Impact of gallstone in gallballder neck which leads to pain on contraction of the gall bladder

Pain worse when eating or when had fatty meal- causes contraction of gall bladder around impacted stone

Mucocele is a mucous fluid which remains in the gall bladder after bile has been reabsorbed due to the biliary stasis caused by the obstruction

Question 2

How might someone with biliary colic present?

Answer 2

Epigastric/RUQ pain
Can radiate to back and shoulder tip (irritation of the diaphragm)
Occurs post-prandial (15-20mins after meal)
Constant pain more severe points (which makes it appear colicky)

Question 3

What would you expect to find on examination in someone suspected of biliary colic?

Answer 3

General well
RUQ tenderness
Np guarding/peritonism

Question 4

What investigations would you do for biliary colic?

Answer 4

FBC- WCC to see if there is infection present
U+E- assess kidney function in case of medication
LFTs= can look for obstructive picture which would indicate stones in common bile duct or cholangitis
Abdo USS= would see gallstons and thin wall (normal) GB

Question 5

How would you manage someone with biliary colic?

Answer 5

Analgesia
Fat-free diet
Outpatiet cholecystectomy= offered to suitable pateints due to the risk of recurrence is very high

Question 6

What symptoms are included as part of the post-cholecystectomy syndrome?

Answer 6

Diarrhoea 
Indigestion 
Epigastric or RUQ pain 
Nausea
Intolerance of fatty food 
Flatulence