胆囊炎只有右上腹疼痛吗?
胆囊炎分为急性胆囊炎和慢性胆囊炎,它们的临床表现有相同但也存在差异。
典型症状
2. 急性梗阻性化脓性胆管炎:主要表现为高热、寒战、腹痛、黄疸、休克、精神症状三联征。严重患者要选择手术治愈本病,术后要注意多休息,注意患处清洁卫生。
什么情况应立即就医
出现上腹部胀痛不适逐渐加剧,伴恶心、呕吐等消化道症状时,应立即就医。
什么情况应及时就医
出现持续性、阵发性疼痛伴肩部放射痛、发热等情况,应及时就医。
需要做的检查
1. 体格检查:可通过触诊观察右上腹胆囊区域是否有压痛,若炎症波及浆膜,可有腹肌紧张及反跳痛,Murphy征阳性。有些病人可触及肿大的胆囊并有触痛,这些体征可以帮助诊断。
2. 血常规检查:可辅助诊断。胆囊炎患者可出现白细胞升高,老年人可不升高。血清谷氨酰转肽酶、碱性磷酸酶常升高为主,部分患者转氨酶可升高,约1/2的患者血清胆红素升高,1/3的患者血清淀粉酶升高。
3. 彩超:彩超检查可很好的诊断胆囊炎。胆囊增大、张力增高,胆汁透声不佳,胆囊壁增厚(>4mm),明显水肿时见“双边征”,胆囊内可有高回声信号(结石表现);合并胆总管结石时,可表现为胆总管增宽及高回声信号。
鉴别判断
1. 消化性溃疡:消化性溃疡的疼痛和饮食之间具有明显的相关性和节律性,上消化道溃疡多位于剑突下,疼痛多呈钝痛、灼痛或饥饿样痛,持续性剧痛提示溃疡穿透或穿孔,常可因精神刺激、饮食不规律、药物影响等因素而诱发。
2. 急性胰腺炎:急性胰腺炎首发症状常为中上腹胀痛。发病初期可有恶心、呕吐,轻度发热。上述症状基础上,腹痛持续不缓解、腹胀逐渐加重,可陆续出现循环、呼吸、肠、肾及肝衰竭。
3. 急性阑尾炎:典型表现是转移性右下腹痛和右下腹固定压痛,疼痛始于脐周或上腹部,待炎症波及阑尾浆膜,腹痛转移并固定于右下腹,常伴有发热。
4. 肝脓肿:肝脓肿典型症状是寒战、高热、肝区疼痛和肝大。体温常可高达39℃-40℃,伴恶心、呕吐、食欲缺乏和周身乏力。肝区钝痛或胀痛多属持续性,严重时或并发胆道梗阻者,可出现黄疸。
以上便是胆囊炎的相关临床表现,大家遇到这种情况,一定要及时就医噢。
![李丹头像](https://image.healthjd.com/da/s100x100_jfs/t1/205084/36/7346/68143/614884fbEfd9ad36f/fd71cfde953e5b52.jpg)
![王东坡头像](https://image.healthjd.com/da/s100x100_jfs/t1/234618/38/22341/15074/667fe7f2Ffd847fb8/4de075e57802ed83.png)
![孙平头像](https://image.healthjd.com/da/s100x100_jfs/t1/224990/35/12959/24464/65e56461Fe93b3905/ece7b716b66612b5.jpg)
![项琦头像](https://image.healthjd.com/da/s100x100_jfs/t1/165869/24/7739/30859/60399b2dE4f239652/f51331b09c0c6358.jpg)
![陈勇头像](https://image.healthjd.com/da/s100x100_jfs/t1/242859/23/5446/35500/65e52b79F7c153348/6df218a8190c8a67.jpg)
![](https://storage.360buyimg.com/jdhhealth-public/laputa/ecf107fd-0a2f-4dfb-8681-590f62deed9a.png)
![胆囊癌早期有什么常见症状?](http://image.healthjd.com/da/jfs/t1/157268/1/512/17891/5feb20d6Ecf2f36d7/4f891a448f1e39cd.jpg)
胆囊癌早期有什么常见症状?
![肿瘤疾病知识](http://image.healthjd.com/da/jfs/t1/148640/27/18364/7880/5fd81cd7Ea041dd07/1f17f0f3e9038129.jpg)
![胆囊炎的症状到底有哪些?](http://image.healthjd.com/da/jfs/t1/168120/3/36/16899/5fec3fa9Ecfe73746/e0d107e4a0e32e3b.jpg)
胆囊炎的症状到底有哪些?
![内科田主任](http://image.healthjd.com/da/jfs/t1/137849/27/17479/101354/5fce1a08Ebdec6b69/de8516c015aa1239.jpg)
![胆囊炎的早期症状表现?](http://image.healthjd.com/da/jfs/t1/175184/25/17614/5627/60dd11efE89a42e27/3261f38311100fd5.jpg)
胆囊炎的早期症状表现?
![外科苗主任](http://image.healthjd.com/da/jfs/t1/135572/1/20439/18192/5fdc0f5eE8dd00db1/aef2b529ac82a995.jpg)
![胆囊癌有什么症状及怎么治疗?](http://image.healthjd.com/da/jfs/t1/148543/10/18709/17410/5fda07b1E80071866/99f04d82576a0260.jpg)
胆囊癌有什么症状及怎么治疗?
![肝胆胃肠知识讲解](http://image.healthjd.com/da/jfs/t1/148324/15/16966/7948/5fc9ffd0E1fbc35d7/ed0ff052c0e8a79c.jpg)
![胆囊炎患者可以吃哪些,不可以吃哪些?](http://image.healthjd.com/da/jfs/t1/192971/17/13528/5212/60f24f3cE1351369e/d996442aa47efdf3.jpg)
胆囊炎患者可以吃哪些,不可以吃哪些?
![内科田主任](http://image.healthjd.com/da/jfs/t1/137849/27/17479/101354/5fce1a08Ebdec6b69/de8516c015aa1239.jpg)
![胰腺炎的早期症状都有哪些呢?](http://image.healthjd.com/da/jfs/t1/147836/10/20963/10945/61c63dc6Ecc6471fd/d5172550adbde3b9.jpg)
胰腺炎的早期症状都有哪些呢?
![柳瑞](http://image.healthjd.com/da/jfs/t1/217749/24/31433/17868/64a64c6bFdeb708ee/7524d639342f80ff.png)
![胆囊息肉患者有哪些症状?](http://image.healthjd.com/da/jfs/t1/193975/27/9484/6080/60d08c4cEbbf943fc/f6131c9311c4ba52.jpg)
胆囊息肉患者有哪些症状?
![内科田主任](http://image.healthjd.com/da/jfs/t1/137849/27/17479/101354/5fce1a08Ebdec6b69/de8516c015aa1239.jpg)
![得了胆囊炎,你害怕吗?](http://image.healthjd.com/da/jfs/t1/142010/22/14563/9222/5fb52513Ee87bbae1/bee66db2ffc997f6.jpg)
得了胆囊炎,你害怕吗?
![周宁医生](http://image.healthjd.com/da/jfs/t1/128666/11/13337/131253/5f6c485dE245bafe6/5c56a7cbba78a4a4.jpg)
![右肋痛、背疼、腿疼是怎么回事?](http://image.healthjd.com/da/jfs/t1/143912/25/16415/24821/5fc47b6fE6da739cb/0cb3eb21c644cd1f.jpg)
右肋痛、背疼、腿疼是怎么回事?
![医学小侦探](http://image.healthjd.com/da/jfs/t1/151393/19/8466/48249/5fc31810E87d5199d/31a99333b88f282d.jpg)
![右上腹疼痛,可能是这些疾病导致的](http://image.healthjd.com/da/jfs/t1/140713/28/15852/14488/5fbf3be3E385f61c7/554e483afb52a6c2.jpg)
右上腹疼痛,可能是这些疾病导致的
![方健](http://image.healthjd.com/da/jfs/t1/96048/11/24990/26803/62394627E1ea4da52/249f329250c142a3.jpg)
![胆囊息肉是怎么形成的有什么危害](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
胆囊息肉是怎么形成的有什么危害
![胆囊炎饮食吃什么好](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
胆囊炎饮食吃什么好
![胆囊炎有哪些症状会发生高烧吗?](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
胆囊炎有哪些症状会发生高烧吗?
![胆囊炎饮食搭配](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
胆囊炎饮食搭配
![胆囊炎会引起口干口苦吗?](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
胆囊炎会引起口干口苦吗?
![上腹不适是什么原因?](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
上腹不适是什么原因?
![萎缩性胆囊炎的症状](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
萎缩性胆囊炎的症状
![女性后背疼是什么病的前兆](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
女性后背疼是什么病的前兆
![胆结石便血是怎么回事](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
胆结石便血是怎么回事
![胁肋痛是怎么回事](https://img14.360buyimg.com/imagetools/jfs/t1/188961/1/44914/13526/664df7c8F6e09623d/c595d1c86d9fda1a.jpg)
胁肋痛是怎么回事
![广告图片](https://storage.360buyimg.com/jdhhealth-public/laputa/3091b328-e8b4-4082-9175-02332118d2ff.png)
![关闭icon](https://storage.360buyimg.com/jdhhealth-public/laputa/d44c4b5b-8206-45b2-85e6-12408f369b3e.png)