CVA tenderness, pulses intact, edema. Laboratory - Minimum Lab. CBC with differential, platelet and reticulocyte counts, urinalysis and culture, SMA 18 for pain not characteristic of pain episodes, change in jaundice, vomiting or diarrhea. Chest x-ray, ECG, and supine and upright abdomen if patient meets admission criteria. Pain is usually diffuse, steady, involves back and extremities, and is characteristic for patient.
Bowel sounds are normal-active.
Diffuse tenderness without guarding or rebound is present. Liver and spleen size is unchanged. Fever less than 101oF and WBC less than 20,000 without left shift. Pain is usually in right upper quadrant, may radiate to right shoulder, chest or epigastrium. Usually severe and steady, may occur after meals, often associated with nausea and vomiting.