Introduction to Gallbladder Ultrasound
Case
- 37 y.o. female
- 1d epigastric pain --> right back
- No past medical history
- Some nausea, no fever, no vomiting, no dysuria
- Mild tenderness to right flank/ RUQ
- UA small blood, not pregnant
- Diagnosis?
- Imaging?
- Treatment?
Narration
37yo With Right Side/ Upper Abdominal Pain
Ultrasound A
Ultrasound B
Narration
Abdominal Pain
-
Abdominal pain: the #1 ED complaint
- Cholelithiasis:
- 10-20% adults in US (20 million)
- 1-3% of these with symptoms annually
-
Renal colic 1 in 11 persons
- 2 million ED visits annually for flank or back pain
- 70% of patients with urolithiasis get a CT
- though CT has not changed management…
- Ultrasound!!!
Narration
Probe Selection And Approach
-
Curvilinear probe
- Can use phased array to scan between ribs
- Recommend start with transverse subcostal window
- Have patient take a deep breath if possible
Narration
Probe Selection And Approach
-
Curvilinear probe
- Can use phased array to scan between ribs
- Can move up (intercostal), lateral (coronal)
- Sagittal views
- May help to have patient turn to left lateral decubitus or even sit or stand
