1. Acute Choleclystits
Complaints : - Acute pain in the right Hypochondrium (under ribs)
-Yello Skin
-Temprture
-Weakness
Anamnsis Morbi : -
-Acute Beginning
-2 Hours
-Analgesics
Anmnsis Vita :-
-Alcohol
-Fatty food
-Fried Food
-Spicy Food
General examination : -
-Visual inspection:
-Yellow Skin
-Dry Tounge
Instrumental Examination : -
-Ultra Sound - Enlargement of Gallblader
-Thickness of wall of Gallblader
-X-Ray – Enlargment of Gallblader
-CT – Scan
Palpation :-
2. -Mussy (Georgievskiy) : Press Between legs of sternocledomstoid and patient feel pain on ker point.
-ker’s point : palpation on the right subribs 1 cm under the ribs and patient feel pain .
-Murphy sign : press on the right subribs 1 cm under the ribs and ask patient to breath in and patient
feel pain.
Percussion:-
From left side to the right side of the lower edge of the ribs
Patient feel pain on the right subribs.
Deffrential Duagnosis : -
Acute Appendsitis Acute Cholyestits
Complaints Acute abdominal pain on the right iliac , No
irradiation.
Acute abdomenal pain in the right subribs under
ribs, irradiation : Right Scapula
Anamnesis morbi - Acute Beginning
- 2 Hours
- Analgesiscs
- Acute Beginning
- 2 Hours
- Analgesiscs
Anamnsis vita No provacative Factor. - Alcohol
- Fatty food
- Spice food
Labaratory Test Blood Test : - Urine test :
-Leukocytosis Protenurian
-Biochemical , No Change
Blood Test :-
-Leukocytosys with left shift formula
-A2T,AST Amylase
-Alkaline phosphatase glucose.
3. Treatment : -
-Hunger (2 – 3 ) days
-Alkalin drink.
-Analgesics
-Anti inflammation theyrapy
-Infusion therapy
*** If Treatment Fail :Urgent Hospitalization To surgery Department.****
