Point-of-Care Ultrasound Assisting in the Rapid Diagnosis of Acute Cholangitis 60 Years After Cholecystectomy.
Kendall Regional Medical Center
Diagnosis | Digestive System Diseases | Emergency Medicine
BACKGROUND: Point-of-care ultrasound (POCUS) is used frequently to evaluate the right upper quadrant of patients with high suspicion for biliary pathology. In patients with a history of cholecystectomy, the utility of POCUS can be overlooked.
CASE REPORT: We report the case of an 83-year-old female patient who was ultimately diagnosed with cholangitis more than 60 years after undergoing cholecystectomy. POCUS demonstrated a dilated common bile duct (CBD), which was confirmed by computed tomography and magnetic resonance cholangiopancreatography to be due to a large stone. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Choledocholithiasis and cholangitis can still occur in patients with a remote history of cholecystectomy. POCUS can be used to rapidly evaluate the CBD for dilatation in patients post cholecystectomy.
Publisher or Conference
Journal of Emergency Medicine
Georges N, Ford C, Moreno M, Zagroba S. Point-of-Care Ultrasound Assisting in the Rapid Diagnosis of Acute Cholangitis 60 Years After Cholecystectomy [published online ahead of print, 2021 Sep 9]. J Emerg Med. 2021;S0736-4679(21)00539-4. doi:10.1016/j.jemermed.2021.07.001