Neonatal Gallstones Serendipitously Discovered by Point-of-Care Ultrasound in the Pediatric Emergency Department

Damman, Jennifer; Doniger, Stephanie J.; Atigapramoj, Nisa S

doi:10.1097/pec.0000000000000622

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…[20][21][22][23][24] In gallbladder diseases, Bedside US has been shown to be 55% to 95% sensitive and 82% to 100% specific for cholelithiasis (i.e., the formation of gallstones) and acute cholecystitis, as well as decreased ED length of stay. [25][26][27][28][29][30][31][32][33][34] In rare deadly biliary diseases, such as emphysematous cholecystitis (i.e., acute infection of the gallbladder wall caused by bacterial gas-forming organisms such as Clostridium or Escherichia coli), Bedside US has been concluded to be useful in aiding identification and diagnosis. 35,36 However, Bedside US has not been uniformly adopted in most settings despite these studies.…”

Section: Introductionmentioning

confidence: 99%

The Use of Bedside Ultrasound for Gallstone Disease Care within a Community-based Emergency Department: A Confirmation Bias

Gunther

Smith

Boura

et al. 2021

Spartan Medical Research Journal

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INTRODUCTION Traditional evaluation for suspicion of gallstone or gallbladder-related disease includes evaluation with a formal technician-performed ultrasound. However, the use of point-of-care bedside ultrasounds (Bedside US) has been shown to be a viable alternative for the diagnosis of gallstones and gallbladder-related diseases. Purpose Statement : The purpose of this study was to evaluate the impact of Bedside US use in gallbladder evaluation on key patient care outcomes within our community-based emergency department setting. METHODS This retrospective study compared the use of no ultrasound (No US), a formal technician performed ultrasound (Tech US) and Bedside US for gallstone and gallbladder related diseases within a community hospital emergency department between January 1, 2015 and January 1, 2018. Initial vitals, lab work, patient socio-demographics, medical history, emergency department length of stay in hours and disposition were reviewed. RESULTS Of a total N = 449 patients included, patients who received a Bedside US had the fewest computerized tomography scans (No US 62% vs. Tech US 29% vs. Bedside US 16%; p < 0.0001), the shortest median emergency department length of stay (No US 4.5 days vs. Tech US 5.0 days vs. Bedside US 3.0 days; p < 0.0001), and were more likely to be discharged home (No US 41% vs. Tech US 55% vs. Bedside US 81%; p = 0.0006) compared to those that received no ultrasound or a formal ultrasound. Patients who received a Bedside US also had the statistically significant highest incidence of prior cholelithiasis (No US 29.4% vs Tech US 14.3% vs. Bedside US 31.3%; p = 0.001) and lowest total median bilirubin levels (No US 0.5 vs. Tech US 0.5 vs. Bedside US 0.3; p = 0.016) when compared to the other two groups. CONCLUSIONS Although there was a confirmation bias, these study results indicate that point-of-care bedside ultrasound could be a viable alternative for gallstones and gallbladder-related diseases with benefits of use in a community hospital setting.

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Section: Introductionmentioning

confidence: 99%

The Use of Bedside Ultrasound for Gallstone Disease Care within a Community-based Emergency Department: A Confirmation Bias

Gunther

Smith

Boura

et al. 2021

Spartan Medical Research Journal

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“…5 Diagnoses have increased in recent years with the widespread use of ultrasonography (USG). 6 Risk factors for gallstones in children including hemolytic disease, parenteral nutrition (PN), cephalosporin (CS) use, choledochal malformation, prematurity, sepsis, short bowel syndrome, cardiac surgery, and genetic factors. 7 The reported incidence of complications caused by gallstones, such as cholecystitis and obstruction, has a wide range.…”

Section: Introductionmentioning

confidence: 99%

Choledochal cyst as an important risk factor for pediatric gallstones in low-incidence populations: A single-center review

Weng

Lee

Yeung

et al. 2020

Pediatrics & Neonatology

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Background: Gallstones are uncommon in infants and children and Asian children are thought to have very low risk. Diagnoses have increased in recent years with the widespread use of ultrasonography (USG). This study aimed to review our experience with risk factors, complications, and treatment of pediatric gallstones in low-incidence populations. Methods: We retrospectively reviewed patients younger than 18 years old diagnosed with gallstones using USG between November 2006 and December 2012 in a tertiary referral hospital in Taiwan. Demographic information including age and sex, follow-up period, USG findings, predisposing factors, complications, treatment approaches and outcomes were recorded. Results: Ninety-eight children with gallstones diagnosed with USG were enrolled and reviewed in our study. Females comprised 55% of patients, with no specific gender tendency. No risk factor could be identified in 30.8% of patients. The most common risk factors were cephalosporin (CS) use, presence of a choledochal cyst (CC), and spherocytosis. CS use was not associated with a higher dissolution rate. The presence of type IVa CC implied a high rate of gallstone recurrence after Roux-en-Y hepaticojejunostomy. Complications were seen in 22.4% of patients, but only two needed emergency stone removal. Expectant management was performed in 61% of patients and 62.5% of them achieved spontaneous resolution; the stone dissolution

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Fettleber und Cholezystopathie

Kaltenbach

Kratzer

2022

Adipositas Bei Kindern Und Jugendlichen

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Neonatal Gallstones Serendipitously Discovered by Point-of-Care Ultrasound in the Pediatric Emergency Department

Cited by 6 publications

References 9 publications

The Use of Bedside Ultrasound for Gallstone Disease Care within a Community-based Emergency Department: A Confirmation Bias

The Use of Bedside Ultrasound for Gallstone Disease Care within a Community-based Emergency Department: A Confirmation Bias

Choledochal cyst as an important risk factor for pediatric gallstones in low-incidence populations: A single-center review

Fettleber und Cholezystopathie

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