Always On EM - Mayo Clinic Emergency Medicine Chapter 40 - The Full Bird and Fumar de Cystica - an EM guide to the gallbladder
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Feb 1, 2025 Dr. Henry Schiller, a Mayo Clinic Professor of Surgery and Army Reserve Lieutenant Colonel, shares his expertise on gallbladder health. He discusses the formation of gallstones and the significance of timely diagnosis. The conversation delves into differentiating gallstones from cholecystitis, highlighting critical imaging techniques like ultrasound and CT scans. Insights into interpreting liver function tests and the complexity of acalculous cholecystitis are explored, along with engaging personal anecdotes from his medical journey.
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Fumar de Cystica Prank
- Alex Finch recalls being tricked by Venk Bellamkonda about diagnosing cholecystitis by smell.
- Bellamkonda joked about "fumar de cystica," pretending he could smell gallbladder inflammation.
Lithogenic Bile and Gallstones
- Gallstones form from lithogenic bile, often due to dietary fat.
- Prairie dogs and certain Native American tribes are predisposed to gallstones due to their naturally lean diets.
Cholecystitis Pain Localization
- Cholecystitis pain localizes when the inflamed gallbladder irritates the abdominal wall.
- This irritation can cause a positive Murphy's sign, but its absence doesn't rule out cholecystitis.