Biliary Colic

Question 1

define biliary colic?

Answer 1

pain resulting from obstruction of the gallbladder or common bile duct, usually by a stone. The pain, which is very severe, is usually felt in the upper abdomen (in the midline or to the right) but can also be poorly localized due to its visceral nature.

Question 2

what is the cause of biliary colic?

Answer 2

Occurs due to contractions of the biliary tree in an attempt to relieve an obstruction

Question 3

What are the risk factors of gallstones?

Answer 3

o	Fair (Caucasian)
o	Fat
o	Fertile
o	Forty
o	Female

Question 4

what is the epidemiology of biliary colic?

Answer 4

• 10-15% of people in the adult Western world will develop gallstones
• Biliary colic is the most common presentation of gallstone disease

Question 5

what are the presenting symptoms of biliary colic?

Answer 5

• Crampy RUQ pain
• Nausea and vomiting
• Pain may radiate to the right scapula
• The pain doesNOTfluctuate and has a tendency to persist
• Individuals may present with pain following ingestion of afatty meal

Question 6

what are the signs of biliary colic on examination?

Answer 6

• RUQ pain and epigastric tenderness

Question 7

what are the appropriate examinations?

Answer 7

• Urinalysis, CXR, and ECG to exclude other causes
• Ultrasound - look for dilatation of CBD
• LFT
• ERCP - can be used theraputically
• CT

Question 8

what is a potential management plan for biliary colic?

Answer 8

• Analgesia
• IV fluids
• NBM
• Surgicaloption is Laparoscopic cholecystectomy
• ERCP can also be used to help remove stones or stent a blocked bile duct

Question 9

what are the potential complications of biliary colic?

Answer 9

• Complications of surgery
o Injury to the bile duct
o Fat intolerance - due to inability to secrete a large amount of bile into the intestine because the patient no longer has a gallbladder
o Post-cholecystectomy syndrome - the presence of abdominal symptoms (e.g. dyspepsia, nausea/vomiting, RUQ pain) after the removal of the gallbladder

Question 10

what is the prognosis of biliary colic?

Answer 10

• GOOD prognosis with appropriate treatment