EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS

ALBAYRAK, LEVENT; sağlam, caner

EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS

Levent ALBAYRAK, (Yozgat Bozok Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, Yozgat, Türkiye)

Caner SAĞLAM (Sağlık Bilimleri Üniversitesi, Bozyaka Eğitim ve Araştırma Hastanesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi

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Yıl: 2022 Cilt: 26 Sayı: 4 Sayfa Aralığı: 352 - 357 Metin Dili: İngilizce İndeks Tarihi: 08-11-2022

EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS

Öz:

Introduction: Acute cholecystitis is one of the common reasons for admission to the emergency department and bedside ultrasonography can assist clinical decision-making in these patients. The aim of this study is to evaluate the test features of bedside ultrasonography performed by emergency physicians in the diagnosis of acute cholecystitis. Materials and Methods: A single-center, prospective observational study was conducted between 01.02.2021 and 01.02.2022 with patients admitted to the emergency department with a preliminary diagnosis of acute cholecystitis. The results of the ultrasonography performed in the emergency department and radiology departments of the patients suffering from right upper quadrant pain with the suspicion of acute cholecystitis were evaluated and the consistency of the interpretations between the reports was compared. Results: The mean age of the 152 patients in the study group was 45.8±9 and 73 were male. Sensitivity, specificity, positive and negative likelihood ratios, accuracy, as well as positive and negative predictive values in acute cholecystitis screening of ultrasonography performed in the emergency department are 84.81 (95%CI: 74.97 - 91.9), 94.52 ( 95%CI: 86.56 - 98.49), 15.48 (95%CI: 5.94 - 40.32), 0.16 (95%CI: 0.09 - 0.27) , 89.47 (95 %CI: 83.47 - 93.86), 94.37 (95%CI: 86.54 - 97.76), 85.19 (95%CI: 77.3 - 90.66) respectively. Conclusion: Bedside ultrasonography performed by emergency physicians is reliable for diagnosing cholecystitis. However, further studies are needed to collect sufficient evidence for the transition to clinical practice.

Anahtar Kelime:

AKUT KOLESİSTİT TANISINDA ACİL SERVİSTE YAPILAN YATAKBAŞI ULTRASONOGRAFİNİN DEĞERLENDİRİLMESİ

Öz:

Giriş: Akut kolesistit, acil servise sık başvuru nedenlerinden biridir ve yatak başı ultrasonografi bu hastalarda klinik karar vermede yardımcı olabilir. Bu çalışmanın amacı, akut kolesistit tanısında acil hekimleri tarafından yapılan yatak başı ultrasonografinin test özelliklerini değerlendirmektir. Gereç ve Yöntem: 01.02.2021-01.02.2022 tarihleri arasında acil servise akut kolesistit ön tanısı ile başvuran hastalarda tek merkezli prospektif gözlemsel çalışma yapılmıştır. Akut kolesistit şüphesi ile sağ üst kadran ağrısı olan hastaların acil servis ve radyoloji servislerinde yapılan ultrasonografi sonuçları değerlendirildi ve raporlar arasındaki yorumların tutarlılığı karşılaştırıldı. Bulgular: Çalışma grubundaki 152 hastanın yaş ortalaması 45,8±9 ve 73'ü erkekti. Acil serviste yapılan ultrasonografi akut kolesistit taramasında duyarlılık, özgüllük, pozitif ve negatif olabilirlik oranları, doğruluk, pozitif ve negatif prediktif değerleri sırasıyla 94.52 (%95CI: 86.56 - 98.49), 15.48 (%95CI: 5.94 - 40.32), 0.16 (%95CI: 0.09 - 0.27), 89.47 (%95 CI: 83.47 - 93.86), 94.37 (%95CI: 86.54 - 97.76), 85.19 (%95 CI: 77.3 - 90.66) olarak saptanmıştır. Sonuç: Acil hekimleri tarafından yapılan yatak başı ultrasonografi kolesistit tanısında güvenilirdir. Bununla birlikte, kliniklerde pratik olarak uygulamak, yeterli kanıt toplamak için daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Peery AF, Crockett SD, Barritt AS, Dellon ES, Eluri S, Gangarosa LM, et al. Burden of gastrointestinal, liver, and pancreatic diseases in the United States. Gastroenterology 2015;149:1731–41.
2. Siddiqui A, MacDonald PS, Chong PS, Jenkins JT, Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg. 2008;195(1):40–7.
3. Sharif S, Vlahaki D, Skitch S, Truong J, Freeman S, Sidalak D, et al. Evaluating the diagnostic accuracy of point-of-care ultrasound for cholelithiasis and cholecystitis in a canadian emergency department. CJEM. 2021;23(5):626–30.
4. Wehrle CJ, Talukder A, Tien L, Parikh S, Devarakonda A, Holsten SB, et al. The Accuracy of Point-of-Care Ultrasound in the Diagnosis of Acute Cholecystitis. Am Surg. 2022;88(2):267-72.
5. Stein JC, Jacoby VL, Vittinghoff E, Wang R, Kwan E, Reynolds T, et al. Differential use of diagnostic ultrasound in u.s. Emergency departments by time of day. West J Emerg Med. 2011;12(1):90-5.
6. Gökçen E, Savrun A, Kuşdoğan M, Çaltekin İ, Albayrak L, Atik D, et al. Ability of Bedside Ultrasonography to Detect Pediatric Nasal Bone Fractures. Laryngoscope. 2021;131(6):1398-1403.
7. Rowland JL, Kuhn M, Bonnin RL, Davey MJ, Langlois SL. Accuracy of emergency department bedside ultrasonography. Emerg Med. 2001;13(3):305-13.
8. Chen L, Zhang Z. Bedside ultrasonography for diagnosis of pneumothorax. Quant Imaging Med Surg. 2015;5(4):618-23.
9. Rubano E, Mehta N, Caputo W, Paladino L, Sinert R. Systematic review: emergency department bedside ultrasonography for diagnosing suspected abdominal aortic aneurysm. Acad Emerg Med. 2013;20(2):128-38.
10. Shah S, Bellows BA, Adedipe AA, Totten JE, Backlund BH, Sajed D. Perceived barriers in the use of ultrasound in developing countries. Crit Ultrasound J. 2015;7(1):28.
11. Hansen W, Mitchell CE, Bhattarai B, Ayutyanont N, Stowell JR. Perception of point-of-care ultrasound performed by emergency medicine physicians. J Clin Ultrasound. 2017;45(7):408-15.
12. Kiewiet JJ, Leeuwenburgh MM, Bipat S, Bossuyt PM, Stoker J, Boermeester MA. A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis. Radiology. 2012;264(3):708-20.
13. Wertz JR, Lopez JM, Olson D, Thompson WM. Comparing the Diagnostic Accuracy of Ultrasound and CT in Evaluating Acute Cholecystitis. AJR Am J Roentgenol. 2018;211(2):92-7.
14. Pinto A, Reginelli A, Cagini L, Coppolino F, Stabile Ianora AA, Bracale R, et al. Accuracy of ultrasonography in the diagnosis of acute calculous cholecystitis: review of the literature. Crit Ultrasound J. 2013;5 Suppl 1:S11.
15. Fagenholz PJ, Fuentes E, Kaafarani H, Cropano C, King D, de Moya M, et al. Computed Tomography Is More Sensitive than Ultrasound for the Diagnosis of Acute Cholecystitis. Surg Infect (Larchmt). 2015;16(5):509-12.
16. Scruggs W, Fox JC, Potts B, Zlidenny A, McDonough J, Anderson CL, et al. Accuracy of ED Bedside Ultrasound for Identification of gallstones: retrospective analysis of 575 studies. West J Emerg Med. 2008;9(1):1-5.
17. Graglia S, Shokoohi H, Loesche MA, Yeh DD, Haney RM, Huang CK, et al. Prospective validation of the bedside sonographic acute cholecystitis score in emergency department patients. Am J Emerg Med. 2021;42:15-9.
18. Miller AH, Pepe PE, Brockman CR, Delaney KA. ED ultrasound in hepatobiliary disease. J Emerg Med. 2006;30(1):69-74.
19. Pereira J, Bass GA, Mariani D, Dumbrava BD, Casamassima A, da Silva AR, et al. Surgeon-performed point-of-care ultrasound for acute cholecystitis: indications and limitations: a European Society for Trauma and Emergency Surgery (ESTES) consensus statement. Eur J Trauma Emerg Surg. 2020;46(1):173-83.
20. Zenobii MF, Accogli E, Domanico A, Arienti V. Update on bedside ultrasound (US) diagnosis of acute cholecystitis (AC). Intern Emerg Med. 2016;11(2):261-4.
21. Arienti V, Di Giulio R, Cogliati C, Accogli E, Aluigi L, Corazza GR; Ultrasound SIMI Study Group. Bedside ultrasonography (US), Echoscopy and US point of care as a new kind of stethoscope for Internal Medicine Departments: the training program of the Italian Internal Medicine Society (SIMI). Intern Emerg Med. 2014;9(7):805-14.
22. Summers SM, Scruggs W, Menchine MD, Lahham S, Anderson C, Amr O, et al. A prospective evaluation of emergency department bedside ultrasonography for the detection of acute cholecystitis. Ann Emerg Med. 2010;56(2):114-22.
23. Shekarchi B, Hejripour Rafsanjani SZ, Shekar Riz Fomani N, Chahardoli M. Emergency Department Bedside Ultrasonography for Diagnosis of Acute Cholecystitis; a Diagnostic Accuracy Study. Emerg (Tehran). 2018;6(1):e11.
24. Tootian TJ, Arabikhan HR, Alamdaran A, Zamani MH. Emergency Medicine Resident versus Radiologist in Detecting the Ultrasonographic Signs of Acute Cholecystitis; a Diagnostic Accuracy Study. Emerg (Tehran). 2018;6(1):e19.
25. MacDonald AA, Richardson M, Sue L, Hakiwai A, Stephenson G, Harman R,et al. Bedside ultrasonography for acute gallstone disease: a diagnostic accuracy study of surgical registrars and emergency medicine physicians. ANZ J Surg. 2020;90(12):2467-71.

APA	ALBAYRAK L, sağlam c (2022). EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. , 352 - 357.
Chicago	ALBAYRAK LEVENT,sağlam caner EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. (2022): 352 - 357.
MLA	ALBAYRAK LEVENT,sağlam caner EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. , 2022, ss.352 - 357.
AMA	ALBAYRAK L,sağlam c EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. . 2022; 352 - 357.
Vancouver	ALBAYRAK L,sağlam c EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. . 2022; 352 - 357.
IEEE	ALBAYRAK L,sağlam c "EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS." , ss.352 - 357, 2022.
ISNAD	ALBAYRAK, LEVENT - sağlam, caner. "EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS". (2022), 352-357.

APA	ALBAYRAK L, sağlam c (2022). EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi, 26(4), 352 - 357.
Chicago	ALBAYRAK LEVENT,sağlam caner EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi 26, no.4 (2022): 352 - 357.
MLA	ALBAYRAK LEVENT,sağlam caner EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi, vol.26, no.4, 2022, ss.352 - 357.
AMA	ALBAYRAK L,sağlam c EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2022; 26(4): 352 - 357.
Vancouver	ALBAYRAK L,sağlam c EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2022; 26(4): 352 - 357.
IEEE	ALBAYRAK L,sağlam c "EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS." İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi, 26, ss.352 - 357, 2022.
ISNAD	ALBAYRAK, LEVENT - sağlam, caner. "EVALUATION OF BEDSIDE ULTRASONOGRAPHY PERFORMED IN THE EMERGENCY DEPARTMENT FOR THE DIAGNOSIS OF ACUTE CHOLECYSTITIS". İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi 26/4 (2022), 352-357.