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A 40 yearz old woman presents to her primary care physician fir recurrent right upper quadrant pain she report 30min episodes of abdominal pain after eating meals especially with fast food meals she has nit had any fever or chills and her episodes always resolve her past medical history include hyperlipidemia morbid obesity and polycystix ovarian syndrome fir whic she take oral contraceptives?

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She also report nausea, vomiting, and loss of appetite on physical exam she has right upper quadrant pain and inspiratory arrest with deep palpation of the area an ultrasound of that area reveals distended gallbladder with thickened gallbladder wall and gallstones?
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She also report nausea, vomiting, and loss of appetite on physical exam she has right upper quadrant pain and inspiratory arrest with deep palpation of the area an ultrasound of that area reveals distended gallbladder with thickened gallbladder wall and gallstones  
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