The Rational Clinical Examination
David L. Simel, Drummond Rennie
Acute Cholecystitis
Robert L. Trowbridge, Nicole K. Rutkowski, Kaveh G. Shojania
Clinical Scenario
Topics Discussed:
cholecystitis, acute
Excerpt:
"A 72-year-old woman with poorly controlled diabetes, coronary
artery disease, and hypertension presents to the emergency department
complaining of nausea and vomiting. As an emergency department resident,
you elicit the history that the patient felt well until 24 hours
ago, when she developed anorexia, followed rapidly by bilious emesis.
She describes mild upper abdominal discomfort but is unable to further localize
the pain. There have been no abnormal bowel movements, gastrointestinal
bleeding, or chest pain...."
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