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Effectiveness of ultrasound screening in right upper quadrant pain: A comparative study in a basic emergency service
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Orientador(es)
Resumo(s)
Background and Aims: The use of ultrasound screening is primarily facilitated by
point‐of‐care ultrasound (POCUS) and its integration into healthcare systems is a
result of the versatility of this imaging technique. This study intends to compare the
accuracy and pertinence of sonographic findings obtained by a sonographer in a
Basic Emergency Service (BES) with that of radiologists at referral hospital (RH) in
Portugal.
Methods: Twenty patients with right upper quadrant (RUQ) pain and suspected
cholecystitis or biliary pathology underwent sonography screening using POCUS in
the BES. They were then forwarded to the RH where a radiologist performed a
conventional ultrasound exam on the same patients. The results of both exams were
compared to determine if the findings obtained in the BES were confirmed by the
radiologist in the RH.
Results: In our sample, 60% of cases were related to biliary pathology, 20% were
liver‐related, 10% had hepatopancreatic biliary etiology, and 10% had unknown
etiology. A strong association between the sonographic findings in the BES and the
RH was found in the variables “Sonographic Murphy sign” (V = 0.859; p = 0.001),
“Cholelithiasis/Gallbladder sludge” (V = 0.840; p = 0.001), and “Intrahepatic biliary
tract dilatation” (V = 0.717; p = 0.006). Adequate measures of agreement between
the findings of the radiographer and radiologist were obtained for the “Sonographic
Murphy sign” (k = 0.664; p = 0.001) and the presence of “Cholelithiasis/Gallbladder
sludge” (k = 0.712; p = 0.000).
Conclusion: Major biliary abnormalities were detected in patients with RUQ pain in
BES using sonography. The correlation between the sonographic findings obtained
by the sonographers at BES and those obtained by radiologists at the RH in Portugal
was strong, showing that POCUS screening could be extended to other similar
settings; however, more studies are needed.
Descrição
Palavras-chave
Abdominal pain Patients POCUS Radiologists Screening Sonographers Ultrasound
Contexto Educativo
Citação
Editora
Wiley