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Body proportions is the study of artistic anatomy, which attempts to explore the relation of the elements of the human body to each other and to the whole. These ratios are used in depictions of the human figure and may become part of an artistic canon of body proportion within a culture.
Fibrosis of the gallbladder is another chronic process that occurs due to repeated acute inflammation (i.e., chronic cholecystitis), resulting in a shrunken, fibrotic (therefore hard), and calcified gallbladder ("porcelain gallbladder"), which typically will not present with Courvoisier's sign and is diagnosed with imaging.
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
The waist–hip ratio or waist-to-hip ratio (WHR) is the dimensionless ratio of the circumference of the waist to that of the hips. This is calculated as waist measurement divided by hip measurement (W ⁄ H). For example, a person with a 75 cm waist and 95 cm hips (or a 30-inch waist and 38-inch hips) has WHR of about 0.79.
Cholecystitis accounts for 3–10% of cases of abdominal pain worldwide. [43] Cholecystitis caused an estimated 651,829 emergency department visits and 389,180 hospital admissions in the US in 2012. [44] The 2012 US mortality rate was 0.7 per 100,000 people. [44] The frequency of cholecystitis is highest in people age 50–69 years old. [43]
A gallstone is a stone formed within the gallbladder from precipitated bile components. [2] The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, [5] and choledocholithiasis refers to the presence of migrated gallstones within bile ducts.
Other indicators include raised indicators of ampulla of vater (pancreatic duct obstruction) such as lipases and amylases. In prolonged cases the international normalized ratio (INR) may change due to a decrease in vitamin K absorption. (It is the decreased bile flow which reduces fat breakdown and therefore absorption of fat soluble vitamins).
Cholescintigraphy for acute cholecystitis has sensitivity of 97%, specificity of 94%. [7] Several investigators have found the sensitivity being consistently higher than 90% though specificity has varied from 73–99%, yet compared to ultrasonography, cholescintigraphy has proven to be superior. [8]