title: 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.affiliation: Department of Medicine, University of Texas Southwestern Medical Center and the Parkland Health and Hospital System, Dallas, Texas 75390-8579, USA.
authors.forename: Adam H
authors.initials: AH
authors.lastname: Miller
authors.forename: Paul E
authors.initials: PE
authors.lastname: Pepe
authors.forename: C Reece
authors.initials: CR
authors.lastname: Brockman
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Delaney
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000328:Adult; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography