This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Surgery, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Jeffrey M. Nicholas, MD, MS
From the Department of Surgery, Emory University School of Medicine, Atlanta, Ga.

Arch Surg. 2002;137:741-742.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

A 28-YEAR-OLD WOMAN, gravida 4, para 3, aborta 0 (35 weeks), presented with a 36-hour history of acute onset of postprandial right upper quadrant pain, nausea, and vomiting. She described similar episodes of this pain during the preceding month. Her physical examination was remarkable for right upper quadrant tenderness, but her temperature was 36.2°C and her white blood cell count was 7.1 x 10³/µL. Ultrasonography of her right upper quadrant showed a distended gallbladder with multiple stones, but results of liver function tests were normal.

The patient was treated conservatively for the presumed diagnosis of acute cholecystitis but became more symptomatic the next day. Initially, a laparoscopic approach was attempted, but because of perihepatic adhesions and the inability to visualize the gallbladder, the abdomen was opened and the findings in Figure 1 and Figure 2 were noted.

Figure 1.

Figure 2.

What Is the Diagnosis?

A. Acute cholecystitis

. . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?