ED ultrasound in hepatobiliary disease

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

Research output: Contribution to journalArticlepeer-review

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
StatePublished - Jan 2006

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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