ED ultrasound in hepatobiliary disease

Adam H. Miller, Paul E. Pepe, C. Reece Brockman, Kathleen A. Delaney

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

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). Final Emergency Department patient assessments based on the RADUS were compared to the EPUS. Over 2-years, 127 patients were enrolled. The sensitivity of the EPUS for detecting stones was 94% (positive predictive value 99%; specificity 96%; negative predictive value 73%). In conclusion, the EPUS is a highly sensitive and reliable indicator of the presence of gallstones.

Original languageEnglish (US)
Pages (from-to)69-74
Number of pages6
JournalJournal of Emergency Medicine
Volume30
Issue number1
DOIs
Publication statusPublished - Jan 2006

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Keywords

  • Biliary colic
  • Cholangitis
  • Cholecystitis
  • Choledocholithiasis
  • Cholelithiasis
  • Common bile duct
  • Emergency evaluation
  • Right upper quadrant pain
  • Sonogram
  • Sonographic Murphy's sign
  • Ultrasound

ASJC Scopus subject areas

  • Emergency Medicine

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