US of Right Upper Quadrant Pain in the Emergency Department: Diagnosing beyond Gallbladder and Biliary Disease

Radiographics : a Review Publication of the Radiological Society of North America, Inc
Gayatri JoshiChristine Menias

Abstract

Acute cholecystitis is the most common diagnosable cause for right upper quadrant abdominal (RUQ) pain in patients who present to the emergency department (ED). However, over one-third of patients initially thought to have acute cholecystitis actually have RUQ pain attributable to other causes. Ultrasonography (US) is the primary imaging modality of choice for initial imaging assessment and serves as a fast, cost-effective, and dynamic modality to provide a definitive diagnosis or a considerably narrowed list of differential possibilities. Multiple organ systems are included at standard RUQ US, and a variety of ultrasonographically diagnosable disease processes can be identified, including conditions of hepatic, pancreatic, adrenal, renal, gastrointestinal, vascular, and thoracic origin, all of which may result in RUQ pain. In certain cases, subsequent computed tomography, magnetic resonance (MR) imaging, MR cholangiopancreatography, or cholescintigraphy may be considered, depending on the clinical situation and US findings. Familiarity with the spectrum of disease processes outside of the gallbladder and biliary tree that may manifest with RUQ pain and recognition at US of these alternative conditions is pivotal for early diag...Continue Reading

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Citations

Nov 14, 2018·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Madhurima SharmaMunish Dev
Sep 10, 2019·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Mark D SugiChristine O Menias
Jun 14, 2019·Abdominal Radiology·Ryan B SchwopeChristopher J Lisanti
Feb 20, 2021·PloS One·Jakob SpogisSascha Kaufmann
May 4, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Ahmad ParvinianAshish R Khandelwal
Oct 17, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Joseph MansourChristine O Menias
Jun 11, 2021·Emergency Radiology·Kiran MadduCarrie Hoff
Mar 25, 2021·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Florence DupriezXavier Bobbia

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