Biliary Colic

Question 1

Define biliary colic

Answer 1

episodic RUQ pain triggered by fatty foods, usually due to the movement of a gallstone blocking the cystic duct

Question 2

s/s of biliary colic

Answer 2

RUQ colicky pain - off/on (episodic) pain in the RUQ
May be triggered with fatty food (triggered gallbladder contraction), after meals, at night, or when laying flat
May feel nausea or vomit

No other systemic signs

Question 3

how long do biliary colic episodes last?

Answer 3

< 6 hours
Biliary colic (episodes <6hrs) → eat → pain → eventually goes away

Question 4

Ix for biliary colic if they came to ED

Answer 4

RUQ U/S ➔ may be able to visualize the blockage ➔ would be able to see acoustic shadowing because light obstructed by the gallstones

consider other imaging as well to rule out other ddx

Question 5

treatment for biliary colic

Answer 5

1. supportive care - pain management (NSAIDs preferred bc don’t wanna stress out the liver)
2. pt education on gallstones and fatty food trigger
3. could offer elective cholecystectomy if s/s are bad and recurrent (not an emergency situation)