Hepatic (biliary) colic

Hepatic (biliary) colic – paroxysmal, traditionally severe pain in the right hypochondrium is a manifestation of various diseases of the biliary tract as a result of a violation of the outflow of bile from the gallbladder or through the common bile duct. In an effort to overcome the obstacle that interferes with the movement of bile, the smooth muscles of the gallbladder and ducts are intensively reduced, which is the cause of pain. Hepatic colic is caused by the movement of bile “sand”, a stone wedged in the biliary tract or its movement, plugs from the mucous masses with cholecystitis, stenosis of the major duodenal papilla during inflammation or tumor growth, and a persistent violation of the motor function of the biliary tract – dyskinesia.

Symptoms and course of hepatic colic . If the gallstone moves back into the cavity of the gallbladder or is pushed into the common bile duct and then into the intestine, the obstruction to the path of bile disappears, and the pain subsides even without medical help. Attacks provoke errors in eating: plentiful, fatty and fried foods, alcohol, cold carbonated drinks, also physical overload, shaky driving. Pain occurs in the right hypochondrium or in the pit of the stomach, it can radiate to the back, the right half of the chest, the right supraclavicular region, the right shoulder blade and the right arm. Nausea and vomiting that do not bring relief, flatulence and stool retention are common. In some patients, the temperature may rise, short-term jaundice may develop.

Recognition of hepatic colic. The causes of an attack of biliary colic are detected by ultrasound examination of the abdominal cavity, cholecystography or intravenous cholangiography, and in the last 2 studies, biliary dyskinesia is also diagnosed. Gastroduodenoscopy is mandatory to examine the area of ​​the Vater nipple.

Treatment of hepatic colic. Relief of an attack of biliary colic with antispasmodics in injections: papaverine, no-shpa, atropine, platifillin, baralgin, also taking nitroglycerin under the tongue. To enhance the therapeutic effect, antispasmodics can be combined with analgin or droperidol. In the absence of effect in a hospital, they resort to novocaine blockade.

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