Cholecystitis and Murphy’s Sign: What You Need to Know to Stay Healthy in 2023

Murphy’s sign is one of the most commonly used diagnostic criteria for cholecystitis. Cholecystitis is a serious disease that affects millions of people around the world. It is a gallbladder inflammation, which is located in the upper right side of the abdomen. Cholecystitis can be caused by several reasons such as gallstones, infections, and trauma. Abdominal pain, fever, and nausea are common symptoms of the illness.

What is Murphy’s Sign?

Murphy’s sign is a clinical exam technique that is used to diagnose cholecystitis. It entails applying pressure to the right upper quadrant of the patient’s abdomen while they take a deep breath. A positive Murphy’s sign occurs when the patient gets pain and stops breathing during the examination.

How to Check Murphy’s Sign?

The examiner should ask the patient to lie down on their back and place their right hand under their head to look for Murphy’s sign. The examiner should next place their left hand slightly below the ribs on the patient’s right upper quadrant of the abdomen. The examiner should then request that the patient take a deep breath. A positive Murphy’s sign occurs when the patient gets pain and stops breathing during the examination.

Sonographic Murphy’s Sign

In addition to the clinical examination, ultrasonography is a common cholecystitis diagnostic technique. A sonographic Murphy’s sign may be performed during an ultrasound. The ultrasound probe is placed over the patient’s gallbladder as they take a deep breath. A positive sonographic Murphy’s sign occurs when the patient experiences pain and stops breathing during the examination.

Positive Murphy’s Sign

A positive Murphy’s sign is a sure sign of cholecystitis. A positive Murphy’s sign is generally accompanied by acute pain in the right upper quadrant of the abdomen. In addition to discomfort, cholecystitis sufferers may have a fever, nausea, and vomiting.

Negative Murphy’s Sign

A negative Murphy’s sign does not always rule out cholecystitis. Patients with cholecystitis may display a negative Murphy’s sign in some situations. If the patient has a negative Murphy’s sign but still has cholecystitis symptoms, another diagnostic test, such as ultrasound or CT scans, may be required.

Treatment for Cholecystitis

The gallbladder is usually removed as part of the treatment for cholecystitis. Depending on the severity of the condition, this can be accomplished by either standard open surgery or laparoscopic surgery. Antibiotics may be recommended in some circumstances to treat the underlying infection.

Nursing Management of Cholecystitis

Monitoring the patient’s symptoms, administering drugs as indicated, and providing emotional support are all part of the nursing management of cholecystitis. Nurses should keep an eye out for symptoms of infection, such as fever and an elevated white blood cell count.

Pain control is also an important aspect of cholecystitis nursing care. In addition, nurses should educate patients on healthy food and lifestyle changes to avoid recurrent gallbladder problems.

Finally, Murphy’s sign is a useful diagnostic tool for cholecystitis. A positive Murphy’s sign is a reliable signal of cholecystitis, and patients who exhibit it should be referred for further diagnostic testing and treatment. Early detection and treatment of cholecystitis can reduce complications and improve patient outcomes.

FAQs

What is Murphy’s sign?

Murphy’s sign is a medical test used to help diagnose cholecystitis, an inflammation of the gallbladder. It is named after John Benjamin Murphy, the American surgeon who first described it in 1906.

How to Check Murphy’s Sign?

Murphy’s sign is checked by palpating the right upper quadrant of the abdomen, just below the costal margin, while the patient is asked to take a deep breath. If the patient experiences pain or abruptly stops breathing, the sign is considered positive.

What is a sonographic Murphy’s sign?

A sonographic Murphy’s sign is a positive sign for cholecystitis on an ultrasound. It is characterized by pain elicited by pressure on the gallbladder with the ultrasound probe during the examination.

What is a positive Murphy’s sign?

A positive Murphy’s sign indicates that the patient is likely suffering from cholecystitis, an inflammation of the gallbladder. This sign is considered one of the most reliable clinical signs of acute cholecystitis.

What does a negative Murphy’s sign indicate?

A negative Murphy’s sign indicates that the patient is unlikely to be suffering from cholecystitis. However, it is important to note that a negative Murphy’s sign does not necessarily rule out other causes of right upper quadrant pain.

How is cholecystitis treated?

Treatment for cholecystitis depends on the severity of the condition. Mild cases can often be managed with pain relief, a low-fat diet, and antibiotics. More severe cases may require surgery to remove the gallbladder (cholecystectomy).

What is the nursing management of cholecystitis?

Nursing management of cholecystitis involves closely monitoring the patient’s symptoms and vital signs, administering pain relief and antibiotics as ordered, and ensuring the patient is adhering to a low-fat diet.

It is also important to educate the patient on the signs and symptoms of complications, such as bile duct obstruction or infection, and to encourage them to seek medical attention if they experience these symptoms.

References

1. American College of Radiology. (2020). ACR Appropriateness Criteria® right upper quadrant pain. Retrieved from https://acsearch.acr.org/docs/71087/Narrative/
2. Tintinalli, J. E., Ma, O. J., Yealy, D. M., Meckler, G. D., Stapczynski, J. S., & Cline, D. M. (2015). Tintinalli’s emergency medicine: a comprehensive study guide. New York: McGraw-Hill Education.

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