Julian Villar, Shane M Summers, Michael D Menchine, J Christian Fox, Ralph Wang
BACKGROUND: Cholelithiasis affects an estimated 20 million people in the United States yearly; 20% of symptomatic patients will develop acute cholecystitis (AC). A recent single-center study estimating test characteristics of point-of-care ultrasonography (POCUS) for the detection of AC, as defined by gallstones plus sonographic Murphy's or pericholecystic fluid or gallbladder wall-thickening, resulted in a sensitivity and specificity of 87% (95% confidence interval [CI] 66-97) and 82% (95% CI 74-88), respectively...
October 2015: Journal of Emergency Medicine
Brent A Becker, Eric Chin, Eric Mervis, Craig L Anderson, Masaru H Oshita, J Christian Fox
BACKGROUND: Measurement of the common bile duct (CBD) has traditionally been considered an integral part of gallbladder sonography, but accurate identification of the CBD can be difficult for novice sonographers. OBJECTIVE: To determine the prevalence of isolated sonographic CBD dilation in emergency department (ED) patients with cholecystitis or choledocholithiasis without laboratory abnormalities or other pathologic findings on biliary ultrasound. METHODS: We conducted a retrospective chart review on two separate ED patient cohorts between June 2000 and June 2010...
January 2014: Journal of Emergency Medicine
Marshall Ross, Michael Brown, Kyle McLaughlin, Paul Atkinson, Jenny Thompson, Susan Powelson, Steve Clark, Eddy Lang
OBJECTIVES: The authors sought to determine the diagnostic test characteristics of bedside emergency physician (EP)-performed ultrasound (US) for cholelithiasis in symptomatic emergency department (ED) patients. METHODS: A search was conducted of MEDLINE, EMBASE, the Cochrane Library, bibliographies of previous systematic reviews, and abstracts from major emergency medicine conference proceedings. We included studies that prospectively assessed the diagnostic accuracy of emergency US (EUS) for cholelithiasis, compared to a criterion reference standard of radiology-performed ultrasound (RADUS), computed tomography (CT), magnetic resonance imaging (MRI), or surgical findings...
March 2011: Academic Emergency Medicine
Timothy B Jang, Wendy Ruggeri, Pamela Dyne, Amy H Kaji
BACKGROUND: Emergency department bedside ultrasonography (EUS) can expedite treatment for patients. However, it is unknown how much experience is required for competency in the sonographic diagnosis of cholelithiasis and cholecystitis. OBJECTIVES: The objective was to assess the learning curve of physicians training in right upper quadrant (RUQ) EUS. METHODS: This was a prospective study at an urban, academic emergency department from August 1999 to July 2006...
November 2010: Academic Emergency Medicine
Shane M Summers, William Scruggs, Michael D Menchine, Shadi Lahham, Craig Anderson, Omar Amr, Shahram Lotfipour, Seric S Cusick, J Christian Fox
STUDY OBJECTIVE: We assess the diagnostic accuracy of emergency physician-performed bedside ultrasonography and radiology ultrasonography for the detection of cholecystitis, as determined by surgical pathology. METHODS: We conducted a prospective, observational study on a convenience sample of emergency department (ED) patients presenting with suspected cholecystitis from May 2006 to February 2008. Bedside gallbladder ultrasonography was performed by emergency medicine residents and attending physicians at an academic institution...
August 2010: Annals of Emergency Medicine
Susanna C Spence, Davis Teichgraeber, Chitra Chandrasekhar
OBJECTIVE: The purpose of this presentation is to review the sonographic spectrum of disease entities evaluated by right upper quadrant (RUQ) sonography on an emergent basis. METHODS: Right upper quadrant sonography was performed on an emergent basis in patients who came to the emergency department with signs and symptoms suspicious for or simulating acute cholecystitis or diseases of the liver and biliary tree. RESULTS: A wide gamut of acute and chronic cholecystitis and diseases of the liver and biliary tree were visualized on RUQ sonography...
April 2009: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Adam H Miller, Paul E Pepe, C Reece Brockman, Kathleen A Delaney
To evaluate the diagnostic accuracy of gallbladder ultrasound performed by emergency physicians (EPUS) in patients with right upper quadrant (RUQ) and epigastric (EPI) pain, adults>18 years of age with RUQ or EPI pain were prospectively evaluated by physical examination, laboratory data, and EPUS followed by a blinded radiology department ultrasound (RADUS). Diagnostic categories included: "normal gallbladder"; "uncomplicated symptomatic cholelithiasis" (uncomplicated SCL; stones present but symptoms and signs relieved and no abnormal blood-work); or "complicated symptomatic cholelithiasis" (CSCL; stones and positive symptoms and signs including abnormal blood-work)...
January 2006: Journal of Emergency Medicine
J L Kendall, R J Shimp
The objectives of this study were to determine the accuracy of Emergency Physicians (EP) performing focused right upper quadrant (RUQ) ultrasound, to quantify how sonographic experience affects accuracy for gallbladder pathology, and to establish the time needed to complete a focused RUQ ultrasound. A convenience sample of patients with suspected gallbladder disease received a focused RUQ ultrasound by an EP. Sonographic findings, number of previous RUQ ultrasounds performed, and time for examination completion were recorded...
July 2001: Journal of Emergency Medicine
M Blaivas, R A Harwood, M J Lambert
OBJECTIVE: To determine whether patients who received emergency screening ultrasound examinations (ESUEs) of the gallbladder by emergency physicians (EPs) have a shorter ED length of stay (LOS) than do those receiving ultrasound studies from radiology. METHODS: A retrospective chart review from July 1995 to August 1998 identified 1,242 patients who received gallbladder ultrasound examinations. Seven hundred fifty-three patients received ESUEs by EPs of varying levels of ultrasound experience...
October 1999: Academic Emergency Medicine
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