Higher quadrant belly ache, often accompanied by means of nausea and vomiting.The pain is frequently severe, can also bog down over several hours (biliary colic), or may additionally progress to cholecystitis, with persistent pain and fever.On exam, there is ache to the big majority of patients with gallstones are asymptomatic. Symptomatic gallstones typically take place with right palpation in the proper higher quadrant (Murphy's sign).Most sufferers with choledocholithiasis document top belly ache, even though a few sufferers may additionally stay asymptomatic. Because entire obstruction of the bile duct by the stone can be intermittent, patients may record episodic jaundice.The preliminary manifestation of choledocholithiasis also can be heralded by way of an episode of cholangitis.Gallstone pancreatitis manifests with usual features of pancreatitis, including epigastric pain, nausea, and vomiting.
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