Referred Pain

Why pain of cholecystitis referred to tip of shoulder ?Nasira Bashir Dr. Sabista Naaz Dr. Dinesh Gupta

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Cervical plexus roots C3 C4 C5 arise from neck, shares plexus with pherenic nerve and supraclavicular nerve. inflamed gall bladder irritates Diaphragm, pain sensation is carried to cervical brachial plexus and felt at sub scapular region and Rt shouder. Fatty meal stimulates more bile accumilation thus distension of bladder and stretch pain.

WELCOME. SIR... IN. CHOLECYTITIS AND EVEN. IN... ACUTE. PANCREATITIS...... ..SOMETIMES.... PAIN. IS. REFERRED TO SHOUDER. BLADES.... THIS. IS. DUE. TO... IRRITATION. OF . PHRENIC. NERVE.. SECONDARY. TO ...... INFLAMMATION. ..OF GALL. BLADDER / PANCREAS

Sir to be more precise because both phrenic nerve supplying the dome of diaphragm and supraclavicular nerves supplying skin over the shoulder , are derived from C3 and C4 spinal segments.
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When your gallbladder is inflamed and swollen, it irritates your phrenic nerve. Your phrenic nerve stretches from the abdomen, through the chest, and into your neck. Each time you eat a fatty meal, it aggravates the nerve and causes referred pain in your right shoulder blade.

Thanks sir, It's is due to sensory overlap of nerves at s.cord Which suplies both GB via pherenic nerve and tip of shoulder via supraclavicular. Hope so ,it's helpful.

Ofcourse !
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