title: Case report: an unrecognized etiology of transient gallbladder pain in heart failure diagnosed with internist-performed point-of-care ultrasound.
abstract: The excellent sensitivity and specificity of right upper quadrant (RUQ) ultrasound for gallbladder pathology in patients with abdominal pain is heavily relied upon in routine diagnostic evaluation. The hour-to-hour timing of this test in a patient with fluctuating symptoms is not widely recognized as having a significant impact on its sensitivity. However, we present a case report describing the essential role of symptom-timed point-of-care ultrasound in making an elusive diagnosis of transient cholecystalgia in a patient with RUQ pain and congestive heart failure (CHF). This case also demonstrates an important etiology of RUQ pain in patients with CHF beyond that of congestive hepatopathy. A review of the related entities of acalculous cholecystitis, congestive hepatopathy, and diffuse gallbladder wall thickening is provided.
authors: Department of Medical Education, Abbott Northwestern Hospital, Graduate Medical Education, Mail Route #11135, 800 E. 28th Street, Minneapolis, MN 55407 USA.
authors: Christine N
authors: CN
authors: Desautels
authors: Department of Medical Education, Abbott Northwestern Hospital, Graduate Medical Education, Mail Route #11135, 800 E. 28th Street, Minneapolis, MN 55407 USA.
authors: David M
authors: DM
authors: Tierney
authors: Minnesota Gastroenterology, 15700 37th Avenue North #300, Plymouth, MN 55446 USA.
authors: Federico
authors: F
authors: Rossi
authors: Department of Medical Education, Abbott Northwestern Hospital, Graduate Medical Education, Mail Route #11135, 800 E. 28th Street, Minneapolis, MN 55407 USA.
authors: Terry K
authors: TK
authors: Rosborough
keywords: Cholecystalgia; Cholecystitis; Gallbladder; Heart failure; Point-of-care ultrasound