Emergency Medicine - RUQ Pain Flashcards Preview

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Flashcards in Emergency Medicine - RUQ Pain Deck (9)
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1
Q

What are you looking for with a HIDA scan (5)?

A
Liver uptake (normal)
 Excretion into duodenum  
Filling of the gallbladder
  Function of the gallbladder   
Biliary tract leaks
2
Q

Roll of morphine with HIDA Scan?

A

Morphine induces sphincter of Oddi contraction. If the gallbladder still doesn’t fill, it suggests acute cholecystitis.

3
Q

Role of CCK administration?

A

Assess the gallbladder ejection fraction in cases of suspected chronic cholecystitis - identify if administration reproduces patient pain.

4
Q

Why do you order a CT scan in a case with RUQ Pain?

A

Rule out intra-abdominal causes of pain aside from cholecystitis (especially in the face of normal RUQ Sonogram and HIDA).

5
Q

Sign on CT (or sonogram) indicative of emphysematous cholecystitis?

A

Air in the wall of the gallbladder.

6
Q

What is the first test of choice for patients complaining of cholecystitis symptoms?

A

RUQ Sonogram

7
Q

What is the diagnostic gold standard for patients complaining of cholecystitis symptoms?

A

HIDA Scan.

8
Q

When should percutaneous drainage of the gallbladder be considered?

A

In very ill or high risk patients.

9
Q

If a patient presents with 5+ days of cholecystitis symptoms, when should surgery be preformed?

A

Patients could be allowed to “cool down” (inflammatory changes) and return approximately 6 weeks later for definitive operative treatment.