Gallbladder Insights in a Flash: Point of Care Ultrasound Unleashed!

Point-of-care ultrasound proves most beneficial when addressing right upper quadrant pain with suspected gallbladder involvement.

Calculi are often invisible on CT scans, highlighting the utility of ultrasound. It exhibits a sensitivity and specificity of 88% and 80% for acute cholecystitis, and 84% and 99% for gallstones, respectively (1).

While radiologists typically handle referrals for acute cholecystitis or gallstones, the question arises: Are non-radiologist doctors as adept at detecting gallbladder pathology using point of care ultrasound compared to radiologists?

A prospective 2010 study (2) evaluated emergency physicians in point of care ultrasound for detecting acute cholecystitis. The study observed 193 patients suspected of acute cholecystitis from May 2006 to February 2008. Of these, 189 received point of care ultrasound by emergency physicians, and 125 underwent additional ultrasound by radiologists for comparison. The test characteristics for point of care ultrasound by emergency physicians showed a sensitivity of 87% and specificity of 82%, while those for radiologists were a sensitivity and specificity of 83% and 86%, respectively. In essence, the test characteristics were comparable for both parties. Therefore, more doctors should contemplate employing point of care ultrasound in cases of suspected acute cholecystitis.

References

1. Costa P, Neves R, Silva A, Bezerra G, Silva C, Ribeiro M, et al., editors. Gallbladder disorders: ultrasound as a first-line imaging examination. Poster presented at: European Congress of Radiology (ECR); 2018: European Congress of Radiology-ECR 2018.
2. Alves P, Monteiro R, Ventosa AR, Claudino M, editors. Acute cholecystitis: what to expect from ultrasound. Poster presented at: European Congress of Radiology (ESR); 2018: European Congress of Radiology-ECR 2018.
3. Summers SM, Scruggs W, Menchine MD, Lahham S, Anderson C, Amr O, et al. A prospective evaluation of emergency department bedside ultrasonography for the detection of acute cholecystitis. Ann Emerg Med. 2010;56(2):114-22.