For the next 24 hours, significant Murphy's sign
Abdominal examination showed tender epigastric area and periumbilical region and a negative Murphy's sign. Her liver was palpable 3cm below the right costal margin without associated splenomegaly.
Initial clinical presentation in children with acute hepatitis suggest acute cholecystitis (pain and guarding associated with right hypochondrium pain, fever and delayed jaundice) and associated with significant ultrasound findings including: a wall thickness greater than 10mm in the gallbladder, 2 or 3 layers of different echogenicities, ultrasonographic Murphy's sign and gallbladder echogenic contents.
Clinical findings on physical examination and the results of laboratory tests do not appear to be of use in differentiating this gallbladder disorder from other more frequent types. The vomiting, upper right quadrant pain, positive Murphy's sign
on sonography and leucocytosis observed in our patients are similar to the findings described in other types of cholecystitis.
Physical examination showed right hypochondriac Murphy's sign
with defense but no contracture.
A physical examination revealed an absence of Murphy's sign
. Transabdominal sonography revealed the following: multiple septa with a honeycomb appearance at the fundus of the gallbladder, the presence of gallstones in the body, and sludge in multiple septa (Figure 1).
Physical exam showed no evidence of tenderness in the right upper quadrant and negative Murphy's sign
. Laboratory findings, including transaminases, lactic dehydrogenase, total bilirubin, alkaline phosphatase, and white blood cell count, were within normal limits.
A positive Murphy's sign
was observed at physical abdominal examination.
The clinical manifestations were fever, right upper quadrant tenderness, and a positive Murphy's sign
. Sonographic findings were a thickened gallbladder wall (defined as wall thickness > 4 mm) in absence of ascitis and hypoalbuminemia, a positive sonographic Murphy's sign
(defined as maximum tenderness of the sonographically localized gallbladder), pericholecystic fluid collection, and no stone(s) in the gallbladder (4).
Hyp, n= (%) 13(92.8%) 11(68.7%) * Murphy's sign
, n= (%) 10(71.4%) 7(43.7%) * Fever >37.50c n= (%) 11(78.5%) 9(56.2) * USG results n (%) * Gall stone 14(100%) 16(100%) * Distended GB with Thickened Wall 12(85.7%) 14(87.5%) * Pericholecystic fluid n (%) 6(42.8%) $(255%) Table 3: Results of Lap.
The biliary tree was normal in calibre and ultrasound Murphy's sign
was positive in 38 cases; 31 patients had complaint of nausea.