Biliary Colic

Gallbladder neck becomes impacted by a gallstone

Aetiology

  • See Gallstones

Pathophysiology

  • Contraction of the gallbladder against the occluded neck results in colicky pain
  • No inflammatory response

Clinical presentation

  • Gradual build-up pain in RUQ, often exacerbated by eating
  • Pain radiates to back/shoulder
  • Associated with indigestion/nausea

Investigations

Imaging

  • USS
  • MRCP and/or ERCP if further clarification needed

LFTs

  • ALP > ALT/AST, ↑ bilirubin

Management

  • Painkillers
  • Low fat diet, weight loss if obese
  • If recurrent episodes of pain, consider cholecystectomy
  • If recurrent episodes of pain and unfit for surgery - ursodeoxycholic acid