Med as (Krag) / Med J (Krag) 2013; 47(4): 226-234.

doi: 10.5937/mckg47-5179
COBISS . SR - ID 205037068
uDK. 616.361-009.7

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DIAGNOSIS AND TREATMENT OF BILIARY COLIC

Nikola Riznic1, Dragan Milovanovic2, Dragan Celikovic3, Dragce Radovanovic4
1Medical Platoon, Kraljevo, Serbian Armed Forces, Serbia
2Department of Clinical Pharmacology, Clinical Center Kragujevac, Faculty of Medical Sciences, University of
Kragujevac, Kragujevac, Serbia
3Center for Gastroenterohepatology, Clinical Center Kragujevac, Kragujevac, Serbia
4Surgery Clinic, Clinical Center Kragujevac, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

ABSTRACT

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Primljen/Received: 18.12.2013.
Prihvaen/Accepted: 30.12.2013.

Colic is a visceral pain in which the stimulus is

transferred by two types of nerve pathways to somatic and
vegetative centers. Clinically, colic is defined as pain caused
by spasm of smooth muscle cells within the hollow organ
wall. The most common cause of biliary colic is
cholelithiasis, with or without associated inflammation in
biliary tract wall, rarely the other diseases of biliary tract.
Differential diagnosis of biliary colic includes a wide range
of diseases outside biliary tract whose clinical features
incorporate right subcostal pain. Complications of biliary
colic are primarily associated with presence of cholelithiasis,
consequent inflammation and bacterial infections.
Appearance of unique, right subcostal pain is usually
sufficient for working diagnosis and institution of emergency
treatment. Clinical examination and additional diagnostics
are aimed at discovering causes of biliary colic and selection
of patients, who should be referred immediately to hospital
or, if already hospitalized, undergo invasive diagnostic and
therapeutic procedures. In acute phase of biliary colic oral
nutrition is ceased and analgesics are used, usually
parenteral. Non-steroidal anti-inflammatory drugs are the
first choice for emergency treatment of biliary colic.
Additional pharmacotherapy includes antispasmodics, antiemetics and water and electrolyte solutions. Surgical
treatment of biliary colic involves primarily cholecystectomy
and rarely percutaneous cholecystostomy or other complex
procedures including the common bile duct surgery and liver
resection in intrahepatic cholelithiasis. A general
practitioner should treat acute episode, perform triage for
urgent hospital treatment and monitor health status of
patients after definitive cure of underlying cause of biliary
colic.
Key words: biliary tract diseases; colic; diagnosis;
therapeutics; general practice.

226

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22, 34000
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E-mail: nikolariznic@yahoo.com

doi: 10.5937/mckg47-5179
COBISS . SR - ID 205037068
uDK. 616.361-009.7

Med as (Krag) / Med J (Krag) 2013; 47(4): 226-234.

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doi: 10.5937/mckg47-5179
COBISS . SR - ID 205037068
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Med as (Krag) / Med J (Krag) 2013; 47(4): 226-234.

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doi: 10.5937/mckg47-5179
COBISS . SR - ID 205037068
uDK. 616.361-009.7

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doi: 10.5937/mckg47-5179
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uDK. 616.361-009.7

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