Biliary Colic

Question 1

Define Biliary Colic:

Answer 1

Pain resulting from obstruction of the gallbladder/bile tract, usually by a stone

Question 2

What are the risk factors for gallstones?

Answer 2

Fair

Fat

Fertile

Forty

Female

Question 3

Why do Gallstones cause Biliary Colic?

Answer 3

There are contractions of the biliary tree in an attempt to relieve an obstruction

Question 4

What are the presenting symptoms of Biliary Colic?

Answer 4

Crampy RUQ pain

Nausea & Vomiting

Pain may radiate to the right scapula

Pain does not fluctuate - has a tendency to persist

(May present as pain following a fatty meal)

Question 5

What are the appropriate investigations for Biliary Colic?

Answer 5

Urinalysis, CXR, ECG to rule out other causes (e.g. basal pneumonia, inferior MI)

Ultrasound - look for dilatation of the CDB/thickening of the Gallbladder wall

LFTs

ERCP - diagnostic and therapeutic

CT

Question 6

Generate a management plan for Biliary Colic:

Answer 6

NBM

IV fluids, Analgesia

Laparoscopic Cholecystectomy

or

ERCP to remove stones or stent bile duct