ArticleCanadian journal of surgery. Journal canadien de chirurgie2014
Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital.
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- A meta-analysis of the performance of ultrasound, hepatobiliary scintigraphy, CT and MRI in the diagnosis of acute cholecystitis.Abdominal radiology (New York) · 2024Pooled it
- Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis.World journal of emergency surgery : WJES · 2023Pooled it
- Should Procalcitonin Be Included in Acute Cholecystitis Guidelines? A Systematic Review.Medicina (Kaunas, Lithuania) · 2023Pooled it
- Association between mean platelet volume and acute cholecystitis in pregnant patients with right upper quadrant pain: A multicenter retrospective cohort study.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- The role of ischemia-modified albumin, presepsin, delta neutrophil index, and inflammatory markers in diagnosing acute cholecystitis.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024Article
- Radiology Imaging Adds Time and Diagnostic Uncertainty when Point of Care Ultrasound Demonstrates Cholecystitis.POCUS journal · 2024Article
- The Role of Different Systemic Inflammatory Indexes Derived from Complete Blood Count in Differentiating Acute from Chronic Calculus Cholecystitis and Predicting Its Severity.Journal of inflammation research · 2024Article
- When Not to Operate on Acute Cases-A Surgeon's Perspective on Rapid Assessment of Emergency Abdominopelvic Computed Tomography.Journal of imaging · 2023Review
- Article
- Effectiveness of ultrasound screening in right upper quadrant pain: A comparative study in a basic emergency service.Health science reports · 2023Article
- Prediction of extensive necrotic change in acute gangrenous cholecystitis.Emergency radiology · 2022Article
- The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease.Medicina (Kaunas, Lithuania) · 2022Review
- A Potential Pitfall in POCUS of the Gallbladder: Beware of the Duodenum.POCUS journal · 2022Article
- Point-of-care ultrasound for evaluating intra-abdominal calcification in the pediatric emergency department: case series and review of literature.The ultrasound journal · 2020Article
- Inter-rater agreement between trained emergency medicine residents and radiologists in the examination of gallbladder and common bile duct by ultrasonography.Emergency radiology · 2017Observational
- Role of Procalcitonin in Evaluation of the Severity of Acute Cholecystitis.The Eurasian journal of medicine · 2016Article
- Update on bedside ultrasound (US) diagnosis of acute cholecystitis (AC).Internal and emergency medicine · 2016Article
- 2016 WSES guidelines on acute calculous cholecystitis.World journal of emergency surgery : WJES · 2016Review
- Signal Intensity of Superb Microvascular Imaging Correlates with the Severity of Acute Cholecystitis.Case reports in gastroenterologyArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute cholecystitis is one of the most common diseases requiring emergency surgery. Ultrasonography is an accurate test for cholelithiasis but has a high false-negative rate for acute cholecystitis. The Murphy sign and laboratory tests performed independently are also not particularly accurate. This study was designed to review the accuracy of ultrasonography for diagnosing acute cholecystitis in a regional hospital.
methodsWe studied all emergency cholecystectomies performed over a 1-year period. All imaging studies were reviewed by a single radiologist, and all pathology was reviewed by a single pathologist. The reviewers were blinded to each other's results.
resultsA total of 107 patients required an emergency cholecystectomy in the study period; 83 of them underwent ultrasonography. Interradiologist agreement was 92% for ultrasonography. For cholelithiasis, ultrasonography had 100% sensitivity, 18% specificity, 81% positive predictive value (PPV) and 100% negative predictive value (NPV). For acute cholecystitis, it had 54% sensitivity, 81% specificity, 85% PPV and 47% NPV. All patients had chronic cholecystitis and 67% had acute cholecystitis on histology. When combined with positive Murphy sign and elevated neutrophil count, an ultrasound showing cholelithiasis or acute cholecystitis yielded a sensitivity of 74%, specificity of 62%, PPV of 80% and NPV of 53% for the diagnosis of acute cholecystitis.
conclusionUltrasonography alone has a high rate of false-negative studies for acute cholecystitis. However, a higher rate of accurate diagnosis can be achieved using a triad of positive Murphy sign, elevated neutrophil count and an ultrasound showing cholelithiasis or cholecystitis.
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