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A Sonographic Murphy sign is a finding when performing diagnostic medical sonography.It is different from the Murphy sign found on physical examination, but both signs are associated with cholecystitis [1] When the sonographer presses directly over the gallbladder, and the patient expresses pain, more than when the sonographer presses anywhere else, this is said to be a positive sonographic ...
Emphysematous cystitis is a rare type of infection of the bladder wall by gas-forming bacteria or fungi. The most frequent offending organism is E. coli . Other gram negative bacteria, including Klebsiella and Proteus are also commonly isolated.
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.
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]
Abdominal ultrasound is commonly used in the setting of abdominal pain or an acute abdomen (sudden and/or severe abdominal pain syndrome in which surgical intervention might be necessary), in which it can diagnose appendicitis or cholecystitis. Ultrasound can also be used if there is suspicion of enlargement of one or more organs, such as used ...
The investigation is usually conducted after an ultrasonographic examination of the abdominal right upper quadrant for a patient presenting with abdominal pain.If the noninvasive ultrasound examination fails to demonstrate gallstones, or other obstruction to the gallbladder or biliary tree, in an attempt to establish a cause of right upper quadrant pain, a cholescintigraphic scan can be ...
Boas' or Boas's sign is hyperaesthesia (increased or altered sensitivity) below the right Hypochondrium or 12th rib region, which can be a symptom in acute cholecystitis (inflammation of the gallbladder). [1] It is one of many signs a medical provider may look for during an abdominal examination. [2]
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.