CASE 31
A 45-year-old female presents to the clinic with concerns over occasional
midepigastric discomfort and nausea/vomiting after eating “greasy meals.”
The symptoms gradually disappear, and she has no further discomfort. She
denies any hematemesis, and pain is worse after eating. She further mentions
that she had elevated cholesterol levels in the past and was on an exercise pro-
gram, but not anymore. On exam, she is afebrile with normal vital signs. Her
physical exam is completely normal with no evidence of abdominal pain. An
abdominal ultrasound is performed and revealed a few gallstones in the gall-
bladder but no thickening of the gallbladder wall.
What factors would you need to consider to assess the need
for cholecystectomy?
What are gallstones made of?
Can gallstones be seen on abdominal x-ray?
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