ED ultrasound in hepatobiliary disease.

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.

• Authors: Adam H Miller, Paul E Pepe, C Reece Brockman, Kathleen A Delaney
• Journal: The Journal of emergency medicine (J Emerg Med) Vol. 30 Issue 1 Pg. 69-74 (Jan 2006) ISSN: 0736-4679 [Print] United States
• PMID: 16434339 (Publication Type: Journal Article)

Topics

• Abdominal Pain (diagnostic imaging)
• Adult
• Diagnosis, Differential
• Emergency Service, Hospital
• Female
• Gallbladder Diseases (diagnostic imaging)
• Humans
• Likelihood Functions
• Male
• Prospective Studies
• Sensitivity and Specificity
• Ultrasonography