Revised Estimates of Diagnostic Test Sensitivity and Specificity in Suspected Biliary Tract Disease

Shea, Judy A.; Berlin, Jesse A.; Escarce, José J.; Clarke, John R.; Kinosian, Bruce; Cabana, Michael D.; Tsai, Wendy W.; Horangic, Nicholas; Malet, Peter F.; Schwartz, J. Sanford; Williams, Sankey V.

doi:10.1001/archinte.1994.00420220069008

Cited by 266 publications

(106 citation statements)

References 34 publications

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“…The general medical condition of our PC patients is a reflection of the older age and a high of appr. 97% (12). In our study, gallbladder wall thickening and hydrops are the most common sonographic appearance for ACC and AAC.…”

Section: Sonographic Appearance Of Acute Cholecystitismentioning

confidence: 54%

Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis

Peters

Kolderman

Peters³

et al. 2014

Journal of the Belgian Society of Radiology

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2 (1,8%) patients. There were 4 (3,6%) abscesses and 2 (1,8%) fistulas post PC. Drain dislodgment was found without sequelae in 8 (7,2%) patients. Elective cholecystectomy was performed in 35/111 (31,5%). Fifty-one of 87 (58,6%) patients with gallstones underwent cholecystectomy; 36/87 (41,3%) did not undergo surgery due to a too short follow-up or death of nonbiliary disease. In the AAC group, there was no recurrent cholecystitis in 17/24 (70,8%) patients; 3/24 (12,5%) underwent surgery and 4/24 (16,6%) patients died in the ICU. Conclusion: PC is a minimally invasive treatment with low complication rate for patients with acute cholecystitis whom considered being at high-risk for urgent cholecystectomy. Good selection (ASA III and IV) and indication is needed in patients with ACC before PC because the majority will be operated later on. AAC can be managed nonoperatively and further treatment might not be needed.

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Section: Sonographic Appearance Of Acute Cholecystitismentioning

confidence: 54%

Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis

Peters

Kolderman

Peters³

et al. 2014

Journal of the Belgian Society of Radiology

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“…Radiology ultrasonography has been shown to be accurate to diagnose cholelithiasis and acute cholecystitis in patients referred from the ED, 16,[21][22][23][24][25][26][27][28][29][30][31] but it is limited by its routine availability and portability. To facilitate throughput, rapidly narrow the differential diagnosis, and institute early treatment, emergency physicians are increasingly using bedside ultrasonography in the initial evaluation of patients with suspected cholecystitis.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Evaluation of Emergency Department Bedside Ultrasonography for the Detection of Acute Cholecystitis

Summers

Scruggs

Menchine

et al. 2010

Annals of Emergency Medicine

129

103

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Study objective: We assess the diagnostic accuracy of emergency physician-performed bedside ultrasonography and radiology ultrasonography for the detection of cholecystitis, as determined by surgical pathology. Methods:We conducted a prospective, observational study on a convenience sample of emergency department (ED) patients presenting with suspected cholecystitis from May 2006 to February 2008. Bedside gallbladder ultrasonography was performed by emergency medicine residents and attending physicians at an academic institution. Emergency physicians assessed for gallstones, a sonographic Murphy's sign, gallbladder wall thickness, and pericholecystic fluid, and the findings were recorded before formal imaging. The test characteristics of bedside and radiology ultrasonography were determined by comparing their respective results to pathology reports and clinical follow-up at 2 weeks.Results: Of the 193 patients enrolled, 189 were evaluated by bedside ultrasonography. Forty-three emergency physicians conducted the ultrasonography, and each physician performed a median of 2 tests. After the bedside ultrasonography, 125 patients received additional radiology ultrasonography. Twenty-six patients underwent cholecystectomy, 23 had pathology-confirmed cholecystitis, and 163 were discharged home to follow-up. Twenty-five were excluded (23 lost to follow-up and 2 unavailable pathology). The test characteristics of bedside ultrasonography were sensitivity 87% (95% confidence interval [CI] 66% to 97%), specificity 82% (95% CI 74% to 88%), positive likelihood ratio 4.7 (95% CI 3.2 to 6.9), negative likelihood ratio 0.16 (95% CI 0.06 to 0.46), positive predictive value 44% (95% CI 29% to 59%), and negative predictive value 97% (95% CI 93% to 99%). The test characteristics of radiology ultrasonography were sensitivity 83% (95% CI 61% to 95%), specificity 86% (95% CI 77% to 92%), positive likelihood ratio 5.7 (95% CI 3.3 to 9.8), negative likelihood ratio 0.20 (95% CI 0.08 to 0.50), positive predictive value 59% (95% CI 41% to 76%), and negative predictive value 95% (95% CI 88% to 99%). Conclusion:The test characteristics of emergency physician-performed bedside ultrasonography for the detection of acute cholecystitis are similar to the test characteristics of radiology ultrasonography. Patients with a negative ED bedside ultrasonography result are unlikely to require cholecystectomy or admission for cholecystitis within 2 weeks of their initial presentation.

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“…8,13,14 In current study, almost 83 % cases of urolithiasis were diagnosed accurately by ultrasound examination of the abdomen as compared to 62 % diagnostic accuracy reported by Haroun AA et al 15 In this study, CECT helped in diagnosis and treatment of 9 patients. Four patients out of 5 suffering from intestinal obstruction were treated surgically and all 5 patients diagnosed as pancreatitis were managed conservatively bases on CECT scan reports.…”

Section: Discussionmentioning

confidence: 49%

Results of emergency management of acute abdomen in adults based on clinical assessment and basic imaging investigations: are advanced imaging techniques always necessary for successful treatment?

Karandikar¹

2016

Int J Res Med Sci

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Revised Estimates of Diagnostic Test Sensitivity and Specificity in Suspected Biliary Tract Disease

Cited by 266 publications

References 34 publications

Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis

Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis

A Prospective Evaluation of Emergency Department Bedside Ultrasonography for the Detection of Acute Cholecystitis

Results of emergency management of acute abdomen in adults based on clinical assessment and basic imaging investigations: are advanced imaging techniques always necessary for successful treatment?

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