Describe the right upper quadrant pain.
Right upper quadrant pain
Typically more severe and prolonged (> 6 hours) than in biliary colic
Postprandial
Radiation to the right scapula (due to referred pain from phrenic nerve irritation)
List other signs and symptoms.
Positive Murphy sign: sudden pausing during inspiration upon deep palpation of the RUQ due to pain
Murphy sign may be falsely negative in patients > 60 years.
Guarding
Fever, malaise, anorexia
Nausea and vomiting
Acute cholecystitis should always be suspected in a patient with a history of gallstones who presents with RUQ pain, fever, and leukocytosis
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