Mr. Stein's pain
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

The take home message:
  • This is not a cliché, history and physical is where it starts.
  • Gallstones are a very common condition.
  • There are two basic types of stones, (1) combined cholesterol and bile salts and (2) pigmentary stones.
  • It's important to know what the two types mean clinically.
  • Beyond pain, nausea and jaundice, gallstones can cause some serious problems.
  • Acute and chronic pancreatitis. Autodigestion is the key.
  • Possible soaponification, shock, ARDS, DIC and more.
  • Longer term complications of pancreatitis include pseudocyst formation, secondary diabetes, malabsorption.
  • Potential long term complications of gallstones include chronic cholecystitis and even adenocarcinoma.
I think I'm getting the hang of this, bring on the quiz.         Back
 

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