E1867. Acute Pain in Right Upper Quadrant of Abdomen: Imaging Evaluation in Emergency Department by Ultrasound
Right upper quadrant abdominal pain is one of the most common reasons for visiting the emergency department. Ultrasonography is the most common readily available and cost effective real time dynamic imaging modality for initial assessment of this pain. Although ultrasound may not be able to pick up every disease with accuracy, it can definitely help in narrow down the differential diagnosis.
Educational Goals / Teaching Points
Help radiologists to identify the sonographic appearance of various diseases causing acute right upper quadrant pain.
Help the physicians to take the next appropiate steps in emergency management for patients.
Target Audience: Radiologist, Emergency Physician
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Imaging Technique: ULTRASOUND using GE LogiqP9 machine.
Major cause of RUQ pan confined to hepatobiliary system ranging from acute cholecystitis, Emphysematous cholecystitis, liver abscess etc which will be discussed separately.
The standard right upper quadrant ultrasound examination includes dedicated examination of liver, gallbladder pancreas, kidneys.
For system wise approach the main causes can be divide system wise:
HEPATIC CAUSES: Acute Hepatitis , Liver Abscess
Biliary Cause: Acute calculus cholecystitis, cholelithiasis, Gallbladder torsion, Choledocolithiasis, Gall bladder carcinoma
Gastro intestinal causes: Subhepatic appendicits, Perforated viscus, Bowel obstruction, peptic ulcer disease
Pancreatic Causes: Acute Pancreatitis
Thoracic cause: Pleural effusion(Rt)
Several disease entities involving different organ system can manifest as RUQ pain which can be identified by US.
Diagnosis by US at emergency is time-saving, prompt, and can avoid unnecessary costly investigations.
It also helps in the urgent decision-making for treatment.