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Related Concept Videos

Acute Pancreatitis I: Introduction01:27

Acute Pancreatitis I: Introduction

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Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
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Acute Pancreatitis II: Clinical Manifestations and Management01:30

Acute Pancreatitis II: Clinical Manifestations and Management

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Appendicitis01:19

Appendicitis

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Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
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Cholecystitis01:20

Cholecystitis

29
Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
29
Acute Pancreatitis I: Introduction01:25

Acute Pancreatitis I: Introduction

24
Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
24

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Updated: May 3, 2026

Enema of Traditional Chinese Medicine for Patients with Severe Acute Pancreatitis
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Does this patient have acute cholecystitis?

Robert L Trowbridge1, Nicole K Rutkowski, Kaveh G Shojania

  • 1Department of Medicine, University of California, San Francisco 94143-0120 , USA.

JAMA
|December 31, 2002
PubMed
Summary

No single symptom or lab test reliably diagnoses acute cholecystitis. Experienced clinicians use a combination of factors and imaging, like ultrasound, to confirm the diagnosis in patients with abdominal pain.

Area of Science:

  • Gastroenterology
  • Diagnostic Medicine
  • Clinical Decision Making

Background:

  • Acute cholecystitis diagnosis is resource-intensive.
  • Few patients with abdominal pain have cholecystitis.

Purpose of the Study:

  • Evaluate if history, physical exam, or labs can identify patients needing imaging for acute cholecystitis.
  • Determine the diagnostic utility of clinical findings and lab tests.

Main Methods:

  • Systematic literature review (1950-2002) of studies on history, physical exam, and lab tests for acute cholecystitis.
  • Included studies with control groups and clear diagnostic criteria.
  • Data abstracted independently by two authors.

Main Results:

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  • No single clinical or laboratory finding could reliably rule in or out acute cholecystitis.
  • Murphy sign and RUQ tenderness had limited diagnostic value (LRs included 1.0).
  • Diagnostic impression of acute cholecystitis has high LR (25-30), but contributing factors are unclear.

    • Conclusions:

    • No single test is sufficient to diagnose or exclude acute cholecystitis.
    • Combinations of findings and clinician gestalt are crucial.
    • Further research needed to characterize pretest probabilities for better diagnostic strategies.