Evaluation of gallstone disease - Tips from Other Journals

Evaluation of Gallstone Disease Diehl and co-workers mannersed a study to determine the relationship between gastrointestinal complaints, physical findings and the mien of gallstones. During a two-year period, 300 patients for whom diagnostic studies of the gallbladder had been ordered were evaluated.

common hundred and twenty-two (40.7 percent) of the patients had definite gallstones> 178 (593 percent) did not have gallstones and serv as ascendency subjects. All of the patients were interviewed and examined by way of research personnel who were blinded to the deductions of the imaging studies. Epigastric pain lasting at least 30 minutes was existing in significantly more patients with gallstones (642 percent) than without gallstones (451 percent) Patients with gallstones were les likely than those without gallstones to experience lower abdominal pain and more likely to have pain radiating to the upper back. Gallstone-associated pain usually occurr more than single hour after meals, persisted from individual to 24 hours and was steady in quality. Colicky pain and nutriment intolerance, commonly associated with gallbladder disease, were les everyday in the patients with gallstones.

The authors decide that although certain symptoms are more usual in patients with gallstone disease, an accurate diagnosis cannot be made upon the basis of clinical assessment alone. Careful clinical evaluation can lead to the selective use of diagnostic imaging. (American Journal of Medicine, July 1990 vol 89 p 29)

COPYRIGHT 1990 American Academy of Family Physicians

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