Right hypochondrial pain leading to a diagnosis of cholestatic jaundice and cholecystitis: a review and case study.
|Authors||Redfern, Vicky and Mortimore, Gerri|
The gallbladder stores bile from the liver and releases it into the duodenum. Imbalance in bile components (typically, cholesterol) can lead to cholelithiasis, the crystallisation of choleliths (gallstones). Cholelithiasis is common, affecting a fifth of people in Western countries. The stones can become lodged in the biliary duct and obstruct bile flow. Bile obstruction affects levels of bilirubin, causing cholestatic jaundice. Associated symptoms include nausea, dark urine and pale stools. Gallstones can also cause cholecystitis, the inflammation of the gallbladder. They also often cause pain (biliary colic), especially sudden-onset, episodic, radiating right hypochondrial pain, and biliary pathology is the main cause of upper abdominal pain. Diagnosing these presentations requires a multispectral, holistic assessment comprising numerous investigations, including clinical history, liver function tests, Murphy's sign and abdominal ultrasound. Treatment is usually gallbladder removal surgery (laparoscopic cholecystectomy), with either bile duct exploration or endoscopic retrograde cholangio-pancreatography (ERCP). Good nurse–patient communication is essential to ensure quality of care. The case study presented here covers the assessment and biliary diagnosis of a female patient presenting with severe right hypochondrial pain. The review of existing evidence and the case study should help hepatobiliary nurses deliver quality care for patients presenting with symptoms of gallstones.
|Keywords||hypochondrial pain; Cholecystitis|
|Digital Object Identifier (DOI)||https://doi.org/10.12968/gasn.2019.17.5.32|
|Web address (URL)||http://hdl.handle.net/10545/623942|
|Publication dates||19 Jun 2019|
|Publication process dates|
|Deposited||28 Jun 2019, 12:25|
|Accepted||01 Apr 2019|
This document is the Accepted Manuscript version of a Published Work that appeared in final form in Gastrointestinal Nursing, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see https://www.magonlinelibrary.com/doi/abs/10.12968/gasn.2019.17.5.32
|Contributors||University of Derby|
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