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Trauma Surg Acute Care Open 2018 30;3(1):e000164. Epub 2018 Jul 30.

Division of Emergency Medicine, Western University, London, Ontario, Canada.

Background: Patients with uncomplicated biliary disease frequently present to the emergency department for assessment. To improve bedside clinical decision making, biliary point-of-care ultrasound (POCUS) in the emergency department has emerged as a diagnostic tool. The purpose of this study is to analyze the usefulness of POCUS in predicting the need for surgical intervention in biliary disease. Read More

Crit Ultrasound J 2018 Jul 12;10(1):14. Epub 2018 Jul 12.

Department of Emergency Medicine, New York-Presbyterian, Brooklyn Methodist Hospital, Brooklyn, NY, USA.

Background: The use of point-of-care ultrasound (POCUS) has become increasingly important in resource-limited settings. It can rapidly diagnose both tropical infectious diseases and more common pathology at the bedside. In these practice settings, POCUS can have a significant impact on management strategies and patient care. Read More

Emerg Radiol 2017 Apr 22;24(2):171-176. Epub 2016 Nov 22.

Department of Emergency Medicine, Tehran University of Medical Sciences, Dr Shariati Hospital, Kargar Ave, Tehran, Iran.

Study Objectives: Bedside emergency ultrasonograAmerican Society of Emergency Radiologyphy is a rapid diagnostic tool in the emergency department (ED). Nevertheless, the learning curve for ultrasound (US) training in various indications has to date not been clearly defined. The aim of the present study was to assess how much a short specialized training program in hepatobiliary US might impact the skills of novice emergency medicine residents. Read More

Acad Emerg Med 2017 03;24(3):281-297

Department of Emergency Medicine, SUNY-Downstate Medical Center, Brooklyn, NY.

Background: Acute cholecystitis (AC) is a common differential for patients presenting to the emergency department (ED) with abdominal pain. The diagnostic accuracy of history, physical examination, and bedside laboratory tests for AC have not been quantitatively described.

Objectives: We performed a systematic review to determine the utility of history and physical examination (H&P), laboratory studies, and ultrasonography (US) in diagnosing AC in the ED. Read More

World J Surg 2016 07;40(7):1688-94

Department of Clinical Science and Education, Department of Surgery, Karolinska Institutet, Södersjukhuset (Stockholm South General Hospital), Sjukhusbacken 10, 118 83, Stockholm, Sweden.

Background: Symptomatic gallstone disease is a common diagnosis in patients with abdominal pain. Ultrasound is considered the gold standard method to identify gallstones. Today the examination may be performed bedside by the treating clinician. Read More

Gastrointest Endosc 2016 Jun 20;83(6):1284-5. Epub 2015 Dec 20.

Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.

Intern Emerg Med 2016 Mar 4;11(2):261-4. Epub 2015 Nov 4.

Centre of Research and Learning in Ultrasound, Department of Internal Medicine, Maggiore Hospital, Bologna, Italy.

Acute cholecystitis (AC) represents a principal cause of morbidity worldwide and is one of the most frequent reasons for hospitalization due to gastroenteric tract diseases. AC should be suspected in presence of clinical signs and of gallstones on an imaging study. Upper abdominal US represents the first diagnostic imaging step in the case of suspected AC. Read More

Korean J Gastroenterol 2015 Jun;65(6):370-4

Department of Gastroenterology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.

Cholangitis and cholecystitis are intra-abdominal infections that show poor prognosis upon progression to sepsis and multiorgan failure. Administration of antibiotics with high antimicrobial susceptibility and removal of infected bile at the initial treatment are important. After undergoing ERCP for diagnostic purposes, a 58-year-old man developed acute cholangitis and cholecystitis accompanied by rhabdomyolysis, multi-organ failure, and severe sepsis. Read More

Intern Emerg Med 2016 Feb 16;11(1):19-30. Epub 2015 Jun 16.

Division of Internal Medicine, Department of Medical and Surgical Sciences DIMEC, University of Bologna S. Orsola-Malpighi Hospital, Via Albertoni 15, 40138, Bologna, Italy.

Gangrenous cholecystitis and perforation are severe complications of acute cholecystitis, which have a challenging preoperative diagnosis. Early identification allows better surgical management. Contrast-enhanced computed tomography (ceCT) is the current diagnostic gold standard. Read More

J Miss State Med Assoc 2015 Mar;56(3):64-6

Modern ultrasound machines are relatively inexpensive to own and simple to operate. Basic ultrasound exams can be easily learned and mastered. As with any clinical exam skill, practice makes perfect. Read More

Eur J Trauma Emerg Surg 2015 Oct 21;41(5):481-92. Epub 2015 Mar 21.

Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, 11219, USA.

Introduction: Point-of-care ultrasonography is increasingly utilized across a wide variety of physician specialties. This imaging modality can be used to evaluate patients rapidly and accurately for a wide variety of pathologic conditions.

Methods: A literature search was performed for articles focused on clinician-performed ultrasonography for the diagnosis of appendicitis, gallbladder disease, small bowel obstruction, intussusception, and several types of renal pathology. Read More

Praxis (Bern 1994) 2014 Jun;103(12):697-703

Chirurgische Klinik, Spitalnetz Bern, Tiefenau.

Ultrasound is an easy to learn and highly efficient diagnostic tool to complete the clinical examination and improve bedside decision-making. In the trauma room, surgeons are often required to make a quick decision as to whether or not a patient needs an emergency intervention or whether further diagnostics are required. For this reason, education of surgeons in performing focused emergency ultrasound is pivotal. Read More

Pain Pract 2014 Feb 15;14(2):E63-8. Epub 2013 Aug 15.

Department of Anaesthesiology, Pain and Palliative Care, IRCH, AIIMS, New Delhi, India.

Introduction: Percutaneous anterior abdominal ultrasound guidance for performing celiac plexus neurolysis is a relatively new but more economical, less time-consuming, more comfortable bedside technique for interventional pain management. Paucity of studies evaluating the efficacy of single-site vs. double-site injections at celiac trunk for ultrasound-guided celiac plexus neurolysis (USCPN) prompted us to conduct a prospective, randomized, single-blind clinical trial to compare USCPN using bilateral paramedian (double needle) technique with unilateral paramedian (single needle) technique. Read More

Emerg Med Clin North Am 2013 Aug 15;31(3):809-29. Epub 2013 Jun 15.

Texas A&M - Christus Spohn Emergency Medicine Residency, 2606 Hospital Boulevard, 5 West, Corpus Christi, TX 78405, USA.

Bedside ultrasound (US) was introduced to the emergency department more than 20 years ago. Since this time, many new applications have evolved to aid the emergency physician in diagnostic, procedural, and therapeutic interventions and the scope of bedside ultrasound continues to grow. Many US scanning techniques easily translate from adult applications to the pediatric population. Read More

J Emerg Med 2013 Oct 13;45(4):598-601. Epub 2013 Jul 13.

Department of Emergency Medicine, Staten Island University Hospital, Staten Island, New York.

Background: Hepatic subcapsular hematoma is an uncommon cause of right upper quadrant pain in the Emergency Department. It must be recognized early, as large volumes of acute blood loss and rupture into the peritoneum carry significant morbidity and mortality. In the absence of gallbladder disease, the differential diagnosis should include liver pathology. Read More

PLoS Negl Trop Dis 2013 13;7(6):e2277. Epub 2013 Jun 13.

Department of General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Background: Identification of dengue patients at risk for progressing to severe disease is difficult. Significant plasma leakage is a hallmark of severe dengue infection which can suddenly lead to hypovolemic shock around the time of defervescence. We hypothesized that the detection of subclinical plasma leakage may identify those at risk for severe dengue. Read More

Ann Emerg Med 2013 Aug 13;62(2):176-9. Epub 2013 Mar 13.

Division of Emergency Medicine Ultrasound, Department of Emergency Medicine, Hospital of University of Pennsylvania, Philadelphia, PA, USA.

Common bile duct stones frequently accompany gallstones and can be identified by a variety of imaging modalities. Little is known about the time course of dilatation of the common bile duct after acute obstruction or of normalization after spontaneous passage of an obstructing stone. We describe a case showing rapid fluctuations in common bile duct diameter during 72 hours in a patient presenting with epigastric pain and vomiting. Read More

Pediatr Emerg Care 2013 Jan;29(1):117-21

Division of Pediatric Emergency Medicine, Department of Pediatrics, Newark Beth Israel Medical Center-Children's Hospital of New Jersey, Newark, NJ, USA.

Acute acalculous cholecystitis is uncommon in pediatrics and more likely to be encountered in adult patients. Signs and symptoms of acute cholecystitis are similar to other causes of acute abdominal pain such as pancreatitis, gastritis, and acute appendicitis, further making diagnosis difficult. We present a case of acute acalculous cholecystitis in a child with cystic fibrosis and discuss the role of emergency physician bedside sonography in the evaluation of right-upper-quadrant pain. Read More

Am J Emerg Med 2012 Nov 12;30(9):1943-9. Epub 2012 Jul 12.

Emergency Department, Hospital Infanta Cristina, Parla, Madrid, Spain.

Purposes: Emergency physician-performed ultrasonography holds promise as a rapid and accurate method to diagnose multiple diseases in the emergency department (ED). Our objective was to assess the initial diagnostic accuracy (first 55 explorations) of emergency physician-performed ultrasonography for multiple categories of ultrasound use after a short training period.

Basic Procedures: This was a prospective observational study conducted at an urban ED from June 2010 to March 2011 in patients with suspected cholecystitis, hydronephrosis, deep vein thrombosis, and different cardiovascular problems. Read More

Am J Surg 2013 Jan 29;205(1):102-8. Epub 2012 Jun 29.

Graduate Entry Medical School, University of Limerick, Limerick, Ireland.

Background: We undertook a systematic review and meta-analysis to compare surgeon-performed ultrasound (SPUS) for suspected appendicitis or gallstone disease to the "gold standard" of pathological examination or radiologist-performed ultrasound (RPUS).

Data Sources: MEDLINE, Embase, trial registries, conference proceedings, and article reference lists were searched to identify trials and/or studies comparing SPUS with pathology or RPUS as the reference standard. Data were abstracted from eligible studies to produce 2 × 2 contingency tables, permitting the calculation of pooled sensitivity and specificity values. Read More

Emerg Med Clin North Am 2011 May;29(2):293-317, viii-ix

Emergency Medicine Residency, Department of Emergency Medicine, Palmetto Health Richland, Columbia, SC 29203, USA.

Abdominal pain is a common presenting complaint in today's emergency department (ED). Disorders related to the liver, gallbladder, and pancreas are responsible for many of these presentations. With the increasing prevalence of gallstones, as well as alcohol use and abuse, the numbers of cases are likely to increase. Read More

Acad Emerg Med 2010 Nov;17(11):1247-52

Department of Emergency Medicine David Geffen School of Medicine at UCLA, UCLA Medical Center, Sylmar, CA, USA.

Background: Emergency department bedside ultrasonography (EUS) can expedite treatment for patients. However, it is unknown how much experience is required for competency in the sonographic diagnosis of cholelithiasis and cholecystitis.

Objectives: The objective was to assess the learning curve of physicians training in right upper quadrant (RUQ) EUS. Read More

Ann Emerg Med 2010 Aug;56(2):123-5

Ann Emerg Med 2010 Aug;56(2):114-22

Department of Emergency Medicine, University of California, Irvine, Orange, USA.

Study Objective: We assess the diagnostic accuracy of emergency physician-performed bedside ultrasonography and radiology ultrasonography for the detection of cholecystitis, as determined by surgical pathology.

Methods: We conducted a prospective, observational study on a convenience sample of emergency department (ED) patients presenting with suspected cholecystitis from May 2006 to February 2008. Bedside gallbladder ultrasonography was performed by emergency medicine residents and attending physicians at an academic institution. Read More

J Emerg Med 2011 Apr 30;40(4):415-8. Epub 2009 Oct 30.

Department of Emergency Medicine, State University of New York Upstate Medical University, Syracuse, New York 13210, USA.

Background: As emergency physicians perform bedside ultrasound with greater frequency, greater numbers of incidental and potentially unfamiliar sonographic findings will be encountered.

Objectives: Illustrate, discuss, and briefly review literature regarding one such finding and diagnosis in right upper quadrant sonography.

Case Report: A middle-aged woman was evaluated in the Emergency Department for abdominal pain. Read More

J Emerg Med 2011 Dec 18;41(6):668-71. Epub 2009 Sep 18.

Department of Emergency Medicine, University of California, Irvine Medical Center, Orange, California, USA.

J Emerg Med 2010 Jun 28;38(5):645-51. Epub 2009 Feb 28.

Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York 11030, USA.

Background: The standard evaluation of patients with right upper quadrant (RUQ) abdominal pain consists of a history and physical examination, laboratory analysis, and radiological investigation. Given the increasing availability of bedside ultrasound in the Emergency Department (ED), a growing proportion of Emergency Physicians are now performing their own ultrasound examinations in patients with RUQ abdominal pain to circumvent diagnostic delays and improve patient care.

Objective: To determine the economic "opportunity" costs of additional radiographic testing after identification of acute cholecystitis by focused ED ultrasound performed by registered diagnostic medical sonographer (RDMS)-certified personnel. Read More

Crit Care 2009 25;13(1):R25. Epub 2009 Feb 25.

Intensive Care Unit of Emergency Department, Careggi Teaching Hospital and University of Florence, Florence, Italy.

Introduction: Delayed diagnosis of intraabdominal pathology in the intensive care unit (ICU) increases rates of morbidity and mortality. Intraabdominal pathologies are usually identified through presenting symptoms, clinical signs, and laboratory and radiological results; however, these could also delay diagnosis because of inconclusive laboratory tests or imaging results, or the inability to safely transfer a patient to the radiology room. In the current study we evaluated the safety and accuracy of bedside diagnostic laparoscopy to confirm the presence of intraabdominal pathology in an ICU setting. Read More

J Emerg Med 2009 Jul 25;37(1):51-6. Epub 2008 Apr 25.

Division of Emergency Ultrasound, Department of Emergency Medicine, University of Massachusetts School of Medicine, Worcester, Massachusetts, USA.

Existing guidelines for the number of ultrasounds required before clinical competency are based not on scientific study but on consensus opinion. The objective of this study was to describe the learning curve of limited right upper quadrant ultrasound. This was a prospective descriptive study. Read More

J Emerg Med 2007 Jul 30;33(1):47-52. Epub 2007 May 30.

Department of Emergency Medicine, Northside Hospital Forsyth, Cumming, Georgia 30041, USA.

Tc-99m-HIDA cholescintigraphy studies of gallbladder (GB) emptying are considered to be the most accurate method to diagnose acute cholecystitis (AC). With increasing use of bedside ultrasound (US) by emergency physicians for the evaluation of GB pathology, it is important to determine the role of cholescintigraphy as an adjunct to emergency ultrasound of the gallbladder. The objective of this study was to determine the utility of cholescintigraphy as an adjunct to bedside ultrasound in the evaluation of Emergency Department (ED) patients with suspected acute cholecystitis. Read More

Emerg Radiol 2006 Oct 29;13(1):3-5. Epub 2006 Jun 29.

Emergency Department, University of Massachusetts School of Medicine, 55 Lake Ave North, Worcester, MA 01543, USA.

Many Emergency Departments (ED) use emergency ultrasonography of the right upper quadrant (RUQ) to capture images of the gallbladder in patients with suspected gallstones. It is unclear what impact this practice has on additional imaging performed by radiology. Patients were enrolled 24 h a day by ED residents and attending physicians who have completed an educational program in limited RUQ ultrasound. Read More

Am J Emerg Med 2005 May;23(3):363-7

Division of Emergency Medicine, Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75390, USA.

Study Objective: To determine if emergency center ultrasound (ECUS) can be of value to emergency physicians in the evaluation of possible ascites and accompanying decisions to perform emergent paracentesis.

Methods: During a 7-month period, patients suspected of having ascites and potentially requiring paracentesis were prospectively entered into a randomized study in an urban public hospital emergency center (>140 000 annual visits). Patients were randomized to receive paracentesis using the traditional or the bedside ECUS-assisted technique. Read More

J Assoc Physicians India 2004 Dec;52:962-5

Dr. Ram Manohar Lohia Hospital, New Delhi - 110001, India.

Aims And Objective: Ultrasonographic determination of gallbladder volume in diabetics [both type I and type 2], it's comparison with a control group, and correlation of gallbladder volume in diabetics with parameters such as age, sex, body mass index, parity, hyperlipidaemia, and autonomic neuropathy.

Materials And Method: Ninety one cases of diabetes mellitus and 40 healthy controls were recruited for the study. A detailed history and physical examination were recorded. Read More

Am Surg 2002 Jan;68(1):65-9

Department of Surgery, Cooper Hospital/University Medical Center, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Camden 08103, USA.

Acute acalculous cholecystitis remains a diagnostic challenge in critically ill trauma patients. Laboratory studies are nonspecific and associated injuries or mental status changes may mask clinical signs and symptoms. We conducted a retrospective study to assess the utility of ultrasound in the diagnosis of acute acalculous cholecystitis. Read More

Emerg Med (Fremantle) 2001 Sep;13(3):305-13

Department of Emergency Medicine, The Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Objectives: To determine which focused ultrasound examinations can be interpreted accurately by emergency physicians who have limited training and experience. To determine whether image quality and/or the operator's level of confidence in the findings correlates with accurate scan interpretation.

Methods: A prospective sample of consenting adult emergency department patients with the conditions was selected for study. Read More

MMW Fortschr Med 2001 Mar;143(13):32-4

Abteilung Allgemeine Chirurgie mit Poliklinik, Chirurgische Universitätsklinik Freiburg.

In the presence of typical ultrasonographic signs (Murphy's sign, established pericholecystitis) in patients with a relevant history and clinical presentation, diagnosis of acute cholecystitis can be established with a high degree of accuracy. As a non-invasive method, ultrasound can be used at the bedside of the severely ill patients, thus enabling the more economical use of more sophisticated and expensive examination methods. In the acute stage, the urgency of surgical intervention can be assessed. Read More

Intensive Care Med 2000 Nov;26(11):1658-63

Department of Critical Care Medicine, CHU Nord, Saint-Etienne, France.

Objectives: To assess the respective value of ultrasonography (US) and morphine cholescintigraphy (MC) in the diagnosis of acute acalculous cholecystitis (AAC).

Design And Setting: Prospective study in an intensive care unit of a university hospital.

Patients And Intervention: Twenty-eight patients with clinically and biologically suspected of AAC. Read More

Am J Emerg Med 2001 Jan;19(1):32-6

Department of Emergency Medicine, Beth Israel Deaconess Medical Center and The Division of Emergency Medicine, Harvard Medical School, Boston, MA 02215, USA.

This article investigates the use of bedside abdominal ultrasonography (BAU) performed by emergency physicians (EPs) to screen patients for cholelithiasis and cholecystitis. In this prospective study EPs performed BAU on 116 patients. Agreement between BAU and formal abdominal ultrasound (FUS) performed in the radiology department for detecting cholelithiasis and cholecystitis was determined using Kappa statistics. Read More

Eur J Ultrasound 1999 Jul;9(3):207-12

Chirurgische Klinik, SHG-Kliniken Völklingen, Richardstr. 5-9, D-66333, Völklingen, Germany.

Objective: The ultrasound-guided drainage of the gallbladder (USDGB) is mainly performed by Seldinger technique. We aim to evaluate the use of the easier performable trocar technique in draining critically ill patients with acute calculous or acalculous cholecystitis.

Patients And Methods: Critically ill patients with acute acalculous (AAC; n=29) or calculous cholecystitis (ACC; n=7) underwent trocar technique application of USD. Read More

Gastroenterol Clin Biol 1998 Feb;22(2):127-31

Service d'Hépato-Gastroentèrologie, CHU Nord, Amiens.

Objective And Methods: The treatment of acute cholecystitis or angiocholitis is often difficult in elderly or very ill patients. The aim of this retrospective study was to assess the efficacy and the results of ultrasound guided percutaneous cholecystostomy in patients with acute cholecystitis or biliary tract obstruction and anesthetic or surgical contraindications.

Results: Thirty patients (25-93 years, 16 men and 14 women) were included in this study. Read More

Surg Clin North Am 1998 Apr;78(2):337-64

Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

As the role of the general surgeon continues to evolve, the surgeon's use of ultrasound will surely influence practice patterns, particularly for the evaluation of patients in the acute setting. With the use of real-time imaging, the surgeon receives "instantaneous" information to augment the physical examination, narrow the differential diagnosis, or initiate an intervention. With select ultrasound examinations, the surgeon can rapidly evaluate adult and pediatric patients who present with an acute abdomen, especially those in shock. Read More

World J Surg 1997 Feb;21(2):149-54

Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong.

Acute biliary pancreatitis is a serious complication of biliary calculous disease and is associated with significant morbidity and mortality. The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute biliary pancreatitis has been the focus of discussion in recent years. In addition, the exact role of laparoscopic cholecystectomy (LC) in the management of acute biliary pancreatitis has not yet been fully defined. Read More

Baillieres Clin Gastroenterol 1995 Mar;9(1):21-36

Department of Radiology, University Hospital Rotterdam, The Netherlands.

Because of the high diagnostic yield, its widespread availability and the possibility of bedside examinations, US has become the imaging modality of choice in patients with acute right upper quadrant pain caused by inflammatory disorders such as liver abscesses, acute cholangitis and acute cholecystitis. Computed tomography (CT) can be reserved for more complex cases. US, often in combination with fluoroscopy, is also widely used to control interventions. Read More

J Trauma 1995 Feb;38(2):248-51

Shriners Burns Institute, Boston, MA 02114.

Objective: We desired to demonstrate the utility of percutaneous cholecystostomy in the evaluation and management of critically ill burn patients with fever and rising cholestatic chemistries.

Design: Retrospective review.

Materials And Methods: Over a 2 1/2-year period there were 411 admissions to a regional adult burn until of whom six patients (1. Read More

J Vasc Interv Radiol 1993 Jul-Aug;4(4):531-7; discussion 537-8

Department of Radiology, University of California Davis Medical Center, Sacramento 95817.

Purpose: The authors evaluated the outcome of 49 hospitalized patients with sepsis and possible acute cholecystitis in whom emergency percutaneous cholecystostomy was attempted on 50 occasions.

Patients And Methods: All cholecystostomy procedures were performed with ultrasound (US) guidance by using either the trocar (n = 35) or the Seldinger (n = 15) technique. Forty of the 50 cholecystostomies (80%) were attempted at the patients' bedside, and 49 of the 50 catheters (98%) were placed successfully. Read More

J Clin Gastroenterol 1992 Oct;15(3):238-41

Gastroenterology Division, Palo Alto Medical Clinic, California 94301.

Acute acalculous cholecystitis is an uncommon but very serious illness, that, if undiagnosed, may lead to gallbladder perforation and death. The condition has numerous causes that result in bile stasis and ischemia leading to inflammation and infection in the gallbladder wall. The bedside diagnosis may be difficult, especially in critically ill patients. Read More

Emerg Med Clin North Am 1992 Feb;10(1):27-46

Division of Emergency Medicine, University of Pittsburgh, PA.

The use of ultrasonography in emergency medicine is an area of rapid growth and controversy. This article reviews the current and future applications of emergency ultrasonography with particular emphasis on the role of bedside scanning by the emergency practitioner. Abdominal, pelvic, and cardiac ultrasonographic applications are reviewed, as are the uses of ultrasonography as an adjunct to the performance of procedures in the Emergency Department. Read More

Radiology 1989 Nov;173(2):481-5

Division of Diagnostic Radiology, University of California, Davis Medical Center, Sacramento, CA 95817.

Emergency percutaneous cholecystostomy was successfully performed in 39 of 40 attempted procedures in 37 hospitalized patients with possible acute cholecystitis. All cholecystostomies were performed with ultrasound guidance and preferentially with the transhepatic route, and all but four were performed at the patient's bedside. The patients had been hospitalized an average of 27 days before the procedure. Read More

Semin Liver Dis 1989 Feb;9(1):7-15

Department of Nuclear Medicine, Veterans Administration Medical Center, New York, NY 10010.

99mTc colloid scans, hepatobiliary scans with IDA derivatives, 67Ga scans, and labeled red blood cells or indium-labeled white blood cells are the major imaging procedures that are currently widely available to visualize the liver. The use of labeled antibodies to a specific tumor is being explored as an investigative procedure but is complicated by the high circulating background activity. In this overview of planar liver radionuclide imaging, it was emphasized that these procedures are noninvasive, may be performed at the bedside, are inexpensive, and provide important data for formulating the further investigation of intrahepatic masses, gallbladder disease, vascular and inflammatory diseases. Read More

AJR Am J Roentgenol 1986 Dec;147(6):1171-5

The clinical and laboratory diagnosis of acute acalculous cholecystitis is difficult, and the reliability of various diagnostic imaging techniques has not been established. The results of several imaging procedures performed over a 6-year period on 56 patients with clinically suspected acute acalculous cholecystitis were evaluated retrospectively. Sonography and CT were both highly sensitive (92% and 100%, respectively) and specific (96% and 100%, respectively). Read More