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The Resus Room

Acute Cholecystitis; making the diagnosis

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8678 Ratings

🗓️ 15 April 2017

⏱️ 19 minutes

🧾️ Download transcript

Summary

Acute cholecystitis is a diagnosis that we make frequently in the Emergency Department. But like all diagnostic work ups there is a lot to know about which parts of the history, examination and bedside tests we can do in the ED that really help either rule in or rule out the disease.

In this podcast we run through some of the key bits of information published in the Commissioning Guide Gallstone disease 2016, jointly published by the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland & the Royal College of Surgeons.

We then concentrate on a recent systematic review of the diagnostic work up for Acute Cholecystitis. Yet again the evidence base brings up some issues to challenge our traditional teaching on the topic but should help polish our management of patients with a differential of Acute Cholecystitis.

Enjoy!

References & Further Reading

Commissioning Guide Gallstone disease 2016

Up to date; Acute Cholecystitis

NICE guidance; Acute Cholecystitis

History, Physical Examination, Laboratory Testing, and Emergency Department Ultrasonography for the Diagnosis of Acute Cholecystitis. Jain A. Acad Emerg Med

Transcript

Click on a timestamp to play from that location

0:00.0

Welcome to the Recess Room podcast.

0:03.8

Five, four, three, two, one, fire.

0:12.9

So hi, and welcome back to the Recess Room podcast.

0:16.2

I'm Simon Lang.

0:17.5

And I'm Rob Fenwick.

0:18.6

And this time we're going to be having a chat about acute

0:20.9

colisisitis and making that diagnosis. So a really core presentation to the emergency department

0:27.7

that no doubt we see cases like this day in, day out. Certainly do. In fact, I saw one

0:33.6

only yesterday, Simon. So this is really good to have a recap. This is a really core topic. Thank you for

0:39.6

bringing it to the table this month. No problem. And a big thanks to our sponsors, AdPrak, yet again,

0:44.9

for making this all possible. So, without further ado, let's crack on with the topic. So there are a few

0:53.0

references and documents that are definitely, definitely worth going to have a look at.

0:57.6

And a lot of this podcast takes some information from the Association of Upper GI Surgeons of Great Britain and Ireland

1:04.1

and the Royal College of Surgeons Commissioning Guide to Galstone Disease, which was published in 2016.

1:12.1

Not only that, but we're going to be running through a paper which looks at the characteristics

1:16.1

of some of those tests that we apply when we're looking at a patient with abdominal pain

1:22.1

and we're thinking about colysisitis.

1:24.9

So a bit of background, Rob, question time. How many people in the UK have gallstones?

1:32.4

Oh, as a percentage or as an absolute number? I don't mind, you may give me an absolute number,

1:37.3

but I'm not quite sure of the current population of the UK at the moment. So possibly a percentage

1:41.4

might be slightly easier to work with.

1:46.6

20%?

...

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