Right hypochondrial pain leading to a diagnosis of cholestatic jaundice and cholecystitis: a review and case study.
Name:
Right hypochondrial pain (anonymous ...
Embargo:
2019-12-19
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188.5Kb
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Accepted manuscript
Abstract
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.Citation
Redefern, V., and Mortimore G. (2019) 'Right hypochondrial pain leading to diagnosis of cholestatic jaundice and cholecystitis: a review and case study', Gastrointestinal Nursing, 17(5), pp. 33-41. doi: 10.12968/gasn.2019.17.5.32.Publisher
MA HealthcareJournal
Gastrointestinal NursingDOI
10.12968/gasn.2019.17.5.32Additional Links
https://www.magonlinelibrary.com/doi/abs/10.12968/gasn.2019.17.5.32Type
ArticleLanguage
enISSN
1479-5248ae974a485f413a2113503eed53cd6c53
10.12968/gasn.2019.17.5.32