Bedside ultrasonography for acute gallstone disease: a diagnostic accuracy study of surgical registrars and emergency medicine physicians.

ANZ Journal of Surgery
Andrew MacDonaldJash Agraval

Abstract

Acute gallstone disease, primarily biliary colic and acute cholecystitis, represents a significant burden on surgical services. Prolonged waiting times for ultrasonography to confirm a diagnosis contributes to inefficiency and delays surgery. Bedside ultrasound offers an opportunity for clinicians make a diagnosis more promptly and streamline acute surgery. This study evaluated the reliability of bedside ultrasound performed by clinicians following local training and a trial of its introduction into clinical practice. This was a prospective inter-rater reliability study of bedside ultrasound scans performed on patients referred for suspected acute gallstone disease. Results were compared with a formal ultrasound scan in the radiology department. Inter-rater agreement for the finding of gallstones and the imaging diagnosis of acute cholecystitis was assessed. A total of 124 patients underwent bedside ultrasound scan, 87 (70.2%) performed by surgical registrars. Mean patient age was 48 years (range 19-92 years) with 95 females (76.6%). Inter-rater reliability for the finding of gallstones showed strong agreement with kappa 0.85 (95% confidence interval 0.76-0.95) whereas for the imaging diagnosis of acute cholecystitis there was ...Continue Reading

References

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Jun 9, 2018·World Journal of Surgery·Camilla GustafssonAnders Sondén

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