The Accuracy of Point-of-Care Ultrasound (POCUS) in Acute Gallbladder Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Protocol
2.2. Inclusion Criteria
2.3. Exclusion Criteria
2.4. Point-of-Care Ultrasound Procedure
2.5. POCUS Findings and Diagnosis
2.6. Clinical Decision after Surgeon POCUS
2.7. Data Recording
2.8. Ethics Approval and Consent
2.9. Statistical Analysis
3. Results
3.1. Demographic Data
3.2. Clinical Presentation
3.3. Surgeon POCUS Diagnosis and Parameters
3.4. Accuracy of POCUS
3.5. Accuracy in Diagnosing Acute Cholecystitis
3.6. Common Bile Duct Assessment
3.7. The Timeframe of POCUS to Radiology or Surgery
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Gender | |
---|---|
Male | 34 |
Female | 66 |
Age | |
Mean age | 50.5 (18–93) |
Presentation | |
RUQ pain | 96 (96%) |
RP elevation | 43 (43%) |
Leukocytosis (WCC > 11 × 109/L) | 34 (34%) |
Murphy’s sign positive | 29 (29%) |
Abnormal LFTs | 27 (27%) |
Fever (temperature > 37.5 °C) | 15 (15%) |
Jaundice | 11 (11%) |
Final POCUS Diagnosis | 100 (%) |
---|---|
Normal findings | 38 (42.7%) |
Symptomatic gallstones/sludge without inflammation | 23 (25.8%) |
Acute gallstone cholecystitis | 24 (27%) |
Acalculous cholecystitis | 5 (5.6%) |
Complicated acute cholecystitis | 3 (3.4%) |
Isolated CBD dilatation | 2 (2.2%) |
Liver pathology | 2 (2.2%) |
Patient Number | Explanation |
---|---|
1 | Inconclusive diagnosis for both POCUS and radiology. |
2 | POCUS diagnosed gallstones. CT scan also diagnosed splenic infarction. This patient would have required CT because of atypical presentation. |
3 | POCUS reported no gallstones. Radiologist diagnosed a gallstone. |
4 | POCUS was unable to visualize the gallbladder content due to gas. Radiologist reported a difficult examination, inconclusive for acute cholecystitis. |
5 | POCUS diagnosed acute cholecystitis. Radiologist identified gallstones but not acute cholecystitis. |
6 | POCUS diagnosed acute calculous cholecystitis. Radiologist reported no acute cholecystitis. |
7 | POCUS diagnosed acute acalculous cholecystitis. Radiology reported no cholecystitis after 21 h of antibiotic therapy. |
8 | POCUS diagnosed acute cholecystitis. CT revealed a superior mesenteric artery thrombus. |
9 | POCUS was unable to visualize the gallbladder content due to gas. Radiologist detected gallstones after the patient had been fasting. |
10 | POCUS detected a gallstone in the gallbladder neck. Radiologist did not see gallstones at 48 h. |
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Dumbrava, B.-D.; Bass, G.A.; Jumean, A.; Birido, N.; Corbally, M.; Pereira, J.; Biloslavo, A.; Zago, M.; Walsh, T.N. The Accuracy of Point-of-Care Ultrasound (POCUS) in Acute Gallbladder Disease. Diagnostics 2023, 13, 1248. https://doi.org/10.3390/diagnostics13071248
Dumbrava B-D, Bass GA, Jumean A, Birido N, Corbally M, Pereira J, Biloslavo A, Zago M, Walsh TN. The Accuracy of Point-of-Care Ultrasound (POCUS) in Acute Gallbladder Disease. Diagnostics. 2023; 13(7):1248. https://doi.org/10.3390/diagnostics13071248
Chicago/Turabian StyleDumbrava, Bogdan-Daniel, Gary Alan Bass, Amro Jumean, Nuha Birido, Martin Corbally, Jorge Pereira, Alan Biloslavo, Mauro Zago, and Thomas Noel Walsh. 2023. "The Accuracy of Point-of-Care Ultrasound (POCUS) in Acute Gallbladder Disease" Diagnostics 13, no. 7: 1248. https://doi.org/10.3390/diagnostics13071248