American Board of Internal Medicine (ABIM) Certification Practice Exam

The typical presentation of biliary colic includes severe abdominal pain lasting how long?

1. 5-10 minutes

2. 15 minutes to 3 hours

3. 1-2 hours

4. 2-4 hours

The correct answer is: 15 minutes to 3 hours

Biliary colic is characterized by severe abdominal pain that generally arises due to the contraction of the gallbladder against a blockage in the bile duct, often caused by a gallstone. This intense pain, commonly localized to the right upper quadrant of the abdomen, can radiate to the back or right shoulder. The typical duration of pain in cases of biliary colic is between 15 minutes to 3 hours. This time frame aligns well with the pathophysiology of the condition, where the pain is acute but self-limiting due to the transient nature of the obstruction. After the stone may pass or the gallbladder relaxes, the severe pain usually resolves. Understanding the clinical presentation of biliary colic helps in differentiating it from other abdominal conditions, such as acute cholecystitis or pancreatitis, which involve different pain characteristics and durations. This knowledge is crucial for making accurate diagnoses and guiding appropriate management strategies.