Friction Rub in Acute Cholecystitis: An Unusual Finding

Gary G. Nicholas, MD; Edward Williams, MD
JAMA. 1971;218(13):1945-1946. doi:10.1001/jama.1971.03190260059027.
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To the Editor.—  The usual signs and symptoms of acute cholecystitis have been well described.1 The picture is one of a patient with pain in the right hypochondrium with associated vomiting and fever. The signs include tenderness with guarding and rigidity in the right hypochondrium, although fibrinous adhesions from the gallbladder to surrounding structures are common findings at the time of operation. A friction rub over the surface of the acutely inflamed gallbladder may not have been previously described.2 The following case report illustrates this finding, not mentioned in standard texts.

Report of a Case.—  A 45-year-old white man with a history of aphasia and memory loss underwent an exploratory craniotomy, at which time a falx meningioma was removed through a left frontoparietal incision. The postoperative course was complicated by severe cerebral edema resulting in a marked expressive aphasia and dense right hemiplegia. Three weeks following surgery, the


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