• Gallstones that occur anywhere in biliary tree
• Cholecystitis- acute/chronic inflammation of gallbladder

Manifestations:

• Severe/steady RUQ pain that may radiate to back, right scapula or shoulder
• Sudden onset, lasting up to 5hrs
• May occur after high fat meal
• Biliary colic or cramping-type pain occurs when stone is lodged in common bile duct
• Physical exam- Positive Murphy's sign- severe pain of RUQ w/inspiratory arrest

Management:

• Ursodiol (Actigall)- dissolve cholesterol stones
• Laparascopic cholecystectomy
• Cholecystectomy- open & traditional (T-tube placement; keep in fowlers position to promote gravity drainage of bile. Removed when bile drainage has subsided & stools returned to a normal brown color)
• Low fat diet
• Freq. meals

Gerentological:

• Inc. w/age- cholesterol saturation of bile increases with age because of increase in hepatic secretion of cholesterol and decrease in bile acid synthesis
• DO NOT exhibit same s/s (Septic shock, oliguria, hypotension, mental status, tachycardia, tachypnea)