A Oviedo-García

J Lopez-Libano

JM Alvarez-Franco

M Algaba-Montes

Critical Ultrasound Journal

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MEETING ABSTRACT Open Access
Usefulness of ultrasonography in the emergency
department to a patient with recurrent
abdominal pain
A Oviedo-García1*, M Algaba-Montes1, J Lopez-Libano2, JM Alvarez-Franco3
From 10th WINFOCUS World Congress on Ultrasound in Emergency and Critical Care
Kuala Lumpur, Malaysia. 16-19 November 2014
Background
Gallbladder cancer (GC) is the most common biliary
tract malignancy, representing 3% of malignant tumors,
and has a high mortality, mainly related regional spread.
Early detection remains difficult, and is often casual
Objective
We present a case of GC, diagnosed at ED, through the
use of US scanning used by EP.
Patients and methods
A patient with abdominal pain, with a final diagnosis of
a GC.
Results
81 year old woman, was admitted to the emergency room
after several consultations at its health center by right
upper quadrant pain of several weeks duration, accompa-
nied by fatigue, weight loss and a feeling of abdominal
distention. On examination he had preserved the vital
signs and had only found tenderness in the right upper
quadrant, without signs of peritoneal irritation. Analytical
emergency were unremarkable. Given the persistence of
pain the EP made an ultrasound exam observing a large
mass occupying the gallbladder bed, hypoechoic lesions
in liver parenchyma, and perihepatic free fluid.
Conclusion
Most are adenocarcinomas (95-98%). The histological
type with better survival is papillary adenocarcinoma.
Produce liver metastases from expansion angiolymphatic
own areas of direct hepatic infiltration. The presenting
symptoms are nonspecific and difficult to differentiate
from other more prevalent diseases such as biliary colic or
chronic cholecystitis. The most common symptom is pain
in right upper quadrant dull and aching. When symptoms
such as jaundice or other constitutional symptoms usually
appear advanced. US is the method of initial diagnosis
image, and when it is diagnosed in early stages is usually
discovered incidentally by ultrasound for another reason,
which can observe a large mass occupying the gallbladder
bed with wall thickening. Furthermore, US is very sensitive
for detecting dilatation of intra/extrahepatic bile duct and
the presence of hepatic metastatic lesions or direct infiltra-
tion of the parenchyma.
Informed consent
The study was conducted in accordance with the ethical
standards dictated by applicable law. Informed consent
was obtained from each owner to enrolment in the
study and to the inclusion in this article of information
that could potentially lead to their identification.
Authors’ details
1Emergency Department, Valme Hospital, Seville, Spain. 2Critical Care
Department, Miramar Hospital, Mallorca, Spain. 3Emergency Department, IB-
Salut, Ibiza, Spain.
Published: 9 March 2015
References
1. Chao TC, et al: Primary carcinoma of the gallbladder. J Clin Oncol 1991,
46:215-21.
2. Zevallos Maldonado C, et al: Ultrasound findings associated to
gallbladder carcinoma. Cir Esp 2014, 92(5):348-55.
doi:10.1186/2036-7902-7-S1-A8
Cite this article as: Oviedo-García et al.: Usefulness of ultrasonography in
the emergency department to a patient with recurrent abdominal pain.
Critical Ultrasound Journal 2015 7(Suppl 1):A8.
* Correspondence: albertoaog1972@hotmail.com
1Emergency Department, Valme Hospital, Seville, Spain
Full list of author information is available at the end of the article
Oviedo-García et al. Critical Ultrasound Journal 2015, 7(Suppl 1):A8
http://www.criticalultrasoundjournal.com/content/7/S1/A8
© 2015 Oviedo-García et al; licensee Springer. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


Usefulness of ultrasonography in the emergency department to a patient with recurrent abdominal pain

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Usefulness of ultrasonography in the emergency department to a patient with recurrent abdominal pain

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