Biliary colic in ER

• Main Authors: Banjac Nada, Đurić Davor
• Format: Article
• Language: English
• Published: City Medical emergency department, Belgrade 2018-01-01
• Series: Halo 194
• Subjects: biliary colic; choice of therapy; forwarding the patient to the surgeon
• Online Access: https://scindeks-clanci.ceon.rs/data/pdf/2334-6477/2018/2334-64771801008B.pdf

Introduction: Biliary colic is the most frequent symptom of disease due to the presence of stone in the gallbladder. It is characterized by pains below the right costal arch spreading towards the right shoulder, nausea, vomiting. Pain may be severe and intermittent lasting for several hours or constant. Objective: To determine incidence of biliary colic and other problems caused in the biliary tract pathology and choose therapy and send for a surgical treatment. Methodology: Retrospective analysis and statistical data processing were applied to obtain data of the biliary colic pathology from the ER Derventa protocol for the period June - December 2017. Results: Out of the total number of patients (8793) for the mentioned period there were 51 (0.58%) patients with the biliary colic diagnosis, male (37.25%), female (62.75%). Most of the patients were in the age group of 40-50 (27.4%). The diagnoses represented were the following: acute cholecystitis 1.9%, acute calculous cholecystitis 21.6%, acutization of chronic calculous cholecystitis 5.9%, chronic calculous cholecystitis 68.6%. The selected therapy was the following: analgesics 7.84%, spasmolytics 23.53%, spasmolytics and infusion solutions 21.6%, analgesics in combination with spasmolytics and infusion solutions 45.91%, opioid analgesics 1.9%. The ER took care and treated 76.47% patients, and 23.53% patients were forwarded for the surgical treatment because the therapy was not successful. Conclusion: 1. To recognize clinical features and determine therapy so that there should not be any life-endangering complications and timely send the patient for the surgical treatment; 2. Lack of an ultra-sound device and biochemical indicators in ERs make it more difficult for the doctors to make a correct assessment of the patient's status and increase the number of patients sent for the surgical examination.