title: My patient has got abdominal pain: identifying biliary problems.
abstract: Right upper quadrant and epigastric abdominal pain are common presenting complaints in the emergency department. With increasing access to point-of-care ultrasound, emergency physicians now have an added tool to help identify biliary problems as a cause of a patient's right upper quadrant pain. Point-of-care ultrasound has a sensitivity of 89.8% (95% CI 86.4-92.5%) and specificity of 88.0% (83.7-91.4%) for cholelithiasis, very similar to radiology-performed ultrasonography. In addition to assessment for cholelithiasis and cholecystitis, point-of-care ultrasound can help emergency physicians to determine whether the biliary system is the source of infection in patients with suspected sepsis. Use of point-of-care ultrasound for the assessment of the biliary system has resulted in more rapid diagnosis, decreasing costs, and shorter emergency department length of stay.
authors.affiliation: Department of Emergency Medicine, University of Ottawa and Ottawa Hospital Research Institute, Canada.
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Woo
authors.affiliation: Department of Emergency Medicine, University of Ottawa and Ottawa Hospital Research Institute, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Taylor
authors.affiliation: Department of Emergency Medicine, Dalhousie University, Canada.
authors.forename: Osama
authors.initials: O
authors.lastname: Loubani
authors.affiliation: Department of Emergency Medicine, Sydney Adventist Hospital, Australia; Department of Emergency Medicine, Royal North Shore Hospital, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Bowra
authors.affiliation: Department of Emergency Medicine, Dalhousie University, Canada; Discipline of Emergency Medicine, Memorial University, Canada; Department of Emergency Medicine, Saint John Regional Hospital, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Atkinson
keywords: PoCUS; Point-of-care ultrasound; cholecystitis; cholelithiasis; emergency medicine; gallbladder