A 40 yo woman presented to the ED with upper quadrant pain since three hours after eating a tasty pizza. She is overweight, she presents feverish (38°C) her skin is nonicteric. The abdomen is soft, there is tenderness on the upper right quadrant, you perform a deep palpation in the subcostal area, and the patient stops breathing for pain.
Is Murphy’s sign useful to make diagnosis of cholecystitis? What about the sonographic Murphy’s sign?
Conclusion
Sonographic Murphy sign is positive when you elicit pain pushing the trasnducer just over the gallbladder; despite this has more accuracy than clinical Murphy’s sign, cholecystitis remains a clinical diagnosis and not a sonographic one, it is achieved through a combination of history, physical examination, laboratory and radiologic testing. Murphy’s sign as any other single clinical finding has not sufficient weight to rule in or rule out this condition alone, the presence of Murphy US sign, dilatation, wall tickness and perycholecistic fluid can give a great contribute.
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