Which presentation is most typical of cholecystitis?

Which presentation is most typical of cholecystitis?

• A. RLQ abdominal pain
• B. RUQ abdominal pain with fever
• C. Epigastric burning without fever
• D. LLQ abdominal pain

Answer: (B)

Cholecystitis causes inflammation of the gallbladder, usually from gallstones blocking the cystic duct. This inflammation typically presents with right upper quadrant pain because that’s where the gallbladder sits, often after a fatty meal, and it is usually accompanied by fever from the inflammatory process. The combination of RUQ tenderness with fever is the most characteristic pattern, and you may also see a positive Murphy sign (inspiratory arrest with RUQ palpation). The other presentations don’t fit as well: pain in the right lower quadrant points more toward appendicitis; epigastric burning without fever suggests gastritis or ulcer disease; left lower quadrant pain suggests diverticulitis or other colonic issues.

Cholecystitis causes inflammation of the gallbladder, usually from gallstones blocking the cystic duct. This inflammation typically presents with right upper quadrant pain because that’s where the gallbladder sits, often after a fatty meal, and it is usually accompanied by fever from the inflammatory process. The combination of RUQ tenderness with fever is the most characteristic pattern, and you may also see a positive Murphy sign (inspiratory arrest with RUQ palpation). The other presentations don’t fit as well: pain in the right lower quadrant points more toward appendicitis; epigastric burning without fever suggests gastritis or ulcer disease; left lower quadrant pain suggests diverticulitis or other colonic issues.