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Gallbladder disease presents chiefly with abdominal pain located in the right upper abdomen. This pain is described as biliary colic. Pain typically occurs suddenly and radiates to the right shoulder and back, depending on several factors, including specific diseases. It can either be constant or episodic and last from minutes to hours.
Referred pain, also called reflective pain, [1] is pain perceived at a location other than the site of the painful stimulus.An example is the case of angina pectoris brought on by a myocardial infarction (heart attack), where pain is often felt in the left side of neck, left shoulder, and back rather than in the thorax (chest), the site of the injury.
Biliary colic, also known as symptomatic cholelithiasis, a gallbladder attack or gallstone attack, is when a colic (sudden pain) occurs due to a gallstone temporarily blocking the cystic duct. [1] Typically, the pain is in the right upper part of the abdomen, and can be severe. [2] Pain usually lasts from 15 minutes to a few hours. [1]
“Dull pain radiating to the jaw, neck, back, shoulder or arm; stabbing pain radiating to the back; constant, dull pain for several minutes.” None of these are a good sign, he says.
Lépine's sign is one of the medical signs of gallbladder disease. It is positive when effleurage (light percussion) with crooked third finger at the point of the gallbladder projection to anterior abdominal wall (Gallbladder point, which is present below right costal margin in mid clavicular line) elicits pain.
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.
Kehr's sign is a classic example of referred pain: irritation of the diaphragm is signaled by the phrenic nerve as pain in the area above the collarbone. This is because the supraclavicular nerves have the same cervical nerves origin as the phrenic nerve, C3, C4, and C5. [citation needed]
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