WellSpan Health
The goal of this interventional, prospective study is to determine the clinical utility of a repeat point-of-care ultrasound of the gallbladder in adult emergency department patients with abdominal pain for which initial imaging is not diagnostic. The main question it aims to answer is: Does a repeat ultrasound improve early identification of gallbladder inflammation? Participants will undergo a repeat ultrasound of the gallbladder while still in the emergency department and will be followed up to determine subsequent diagnoses, disposition, consultations and other clinical information.
Acute cholecystitis is a frequent cause of abdominal pain leading to emergency department (ED) evaluation and accounts for approximately 200,000 cases annually in the US (1). Ultrasound (US) is the first-line diagnostic test, but early disease may produce equivocal or negative findings. This diagnostic uncertainty can lead to delayed treatment or the need for additional imaging, such as computed tomography (CT) or a hepatobiliary iminodiacetic acid (HIDA) scan. Recent research has shown that inflammatory changes of the gallbladder may evolve over several hours during the acute presentation. Re…
Inclusion Criteria: * ≥ 18 years of age * Presenting to the emergency department with abdominal pain with clinical concern for possible acute cholecystitis * Initial biliary US interpreted as normal, equivocal or negative for acute cholecystitis * 2-6 hours since initial biliary ultrasound with ongoing symptoms * General surgery consult placed or additional non-ultrasound advanced imaging ordered * Fluency in English or Spanish Exclusion Criteria: * \< 18 years of age * \> 6 hours since initial biliary US * Asymptomatic/resolved symptoms or pending discharge from the emergency department *…
Repeat biliary point of care ultrasound to be performed 2-6 hours following initial ultrasound imaging study
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