Findings: Spotting Acute Cholecystitis on POCUS: What to Look For, What Fools You, and Why it Matters

POCUS Findings There are six classic ultrasound findings you’re looking for in acute cholecystitis:1,6,8,11,12 Gallstones: A bright (hyperechoic) focus inside the gallbladder with a dark shadow behind it, referred to as posterior acoustic shadowing which is the hallmark of a gallstone. Gallstones alone are not indicative of cholecystitis, there must…

Spotting Acute Cholecystitis on POCUS: What to Look For, What Fools You, and Why it Matters

A 45-year-old woman with no past medical history presents to the emergency department with right upper quadrant pain that started about 10 hours ago, shortly after dinner. She’s had intermittent episodes like this before, usually after eating fatty or greasy foods, but they always dissipated within a few hours. This…

Original Article

Cholecystectomy for Biliary Dyskinesia in Gastroparesis: Mimic or Misfortune?

Objectives: Biliary dyskinesia and gastroparesis are associated with upper abdominal discomfort and dyspeptic symptoms in the absence of structural abnormalities. We hypothesized that the similarity in symptoms would trigger testing and surgical treatment for biliary abnormalities in a significant number of patients, with refractory symptoms ultimately demonstrating impairment of gastric…

Case Report

Intramural Gallstones Mimicking Typical Lithiasic Cholecystitis

Gallstone disease is common in the western population. Intramural gallstones are rare, with only a few cases reported in the literature. We present a 30-year-old female patient with typical symptoms of cholecystitis. The patient underwent laparoscopic cholecystectomy one month later. Dark greenish intramural gallstones were identified right after the resection…

Case Report

Acute Acalculous Cholecystitis Simulating Mirizzi Syndrome: A Very Rare Condition

Abstract:Mirizzi syndrome, a rare complication of chronic cholelithiasis, is caused by an impacted stone in the cystic duct or the neck of the gallbladder. Patients present with abdominal pain, fever, and obstructive jaundice. The cholangiographic finding is a smooth stricture caused by lateral compression of the common hepatic duct. A…

Original Article

Association of Clinical and Laboratory Variables With Ultrasound Findings in Right Upper Quadrant Abdominal Pain

Background: The purpose of this study was to determine how laboratory values and physical examination findings correlate with ultrasound findings in the setting of right upper quadrant pain. Methods: Patients undergoing emergent ultrasound for the evaluation of biliary disease between November 1999 and April 2000 were included. Physical examination findings,…