What are the differential diagnoses for gallstones?

The differential diagnosis of gallstones mainly includes the distinction between symptoms related to cholecystitis, cholangitis and pancreatitis. The key to distinguishing these diseases is to recognize their respective clinical manifestations and laboratory test results, so as to avoid misdiagnosis and choose the correct treatment plan.

Cholecystitis often occurs in combination with gallstones, with symptoms of severe pain in the right upper abdomen, fever, and elevated body temperature, which often worsens after eating a high-fat diet; ultrasound examinations show thickening of the gallbladder wall, and the shadow of the stones may be seen. Cholangitis can be caused by gallstones blocking the common bile duct. Typical symptoms include Charcot's triad: abdominal pain, jaundice, and fever. Laboratory tests often show elevated alkaline phosphatase and direct bilirubin. Pancreatitis may be caused when gallstones block the end of the common bile duct, presenting with acute, persistent severe pain in the upper abdomen, accompanied by nausea and vomiting. Significant elevation of serum amylase or lipase is an important auxiliary diagnostic basis.

In the corresponding identification, timely imaging examinations such as ultrasound, CT and magnetic resonance cholangiopancreatography (MRCP) are essential. For cholecystitis and cholangitis, antibiotic treatment is the first choice for infection. In severe cases, ERCP stone removal or biliary drainage should be considered. Pancreatitis requires fasting, fluid replacement and supportive therapy to avoid early surgical intervention. In order to prevent and reduce the occurrence of gallstones and their complications, it is recommended to maintain a healthy diet, consume more fiber-rich foods such as whole grains, vegetables and fruits, and increase exercise appropriately. If symptoms such as persistent abdominal pain and jaundice occur, you should seek medical attention in time for detailed examination and clear diagnosis to avoid delaying treatment. Maintaining a good lifestyle can help reduce the risk of gallstones and related diseases and improve the overall quality of life.