A) Right upper quadrant post-prandial pain with gallstones seen on point of care ultrasound (POCUS)
Patients with symptomatic cholelithiasis whose pain can be controlled can be discharged home for medical management or later elective cholecystectomy as needed. Patients with acute cholecystitis need to be admitted for cholecystectomy. Acute cholecystitis is diagnosed by POCUS with gallbladder wall thickening > 3-4mm, pericholecystic fluid, or a sonographic Murphy’s sign (maximal abdominal tenderness when the ultrasound probe is over the gallbladder). Patients may also have fever and/or leukocytosis.
April 23, 2019 at 3:29 pm
A) Right upper quadrant post-prandial pain with gallstones seen on point of care ultrasound (POCUS)
Patients with symptomatic cholelithiasis whose pain can be controlled can be discharged home for medical management or later elective cholecystectomy as needed. Patients with acute cholecystitis need to be admitted for cholecystectomy. Acute cholecystitis is diagnosed by POCUS with gallbladder wall thickening > 3-4mm, pericholecystic fluid, or a sonographic Murphy’s sign (maximal abdominal tenderness when the ultrasound probe is over the gallbladder). Patients may also have fever and/or leukocytosis.