Begin Treating Acute Cholecystitis Based on Point-of-Care Ultrasound Findings

The incidence of acute cholecystitis continues to increase. Its diagnosis in the emergency department (ED) is often made by clinician gestalt based on the history and physical examination, serum laboratory tests, and point-of-care ultrasound studies. These investigators performed a meta-analysis to determine the test characteristics of each of these modalities for diagnosis in ED patients with suspected acute cholecystitis.

Nine prospective studies involving 1990 patients met inclusion criteria. There was substantial heterogeneity among the studies. None of the individual findings in the history and physical examination (fever, vomiting, jaundice, Murphy's sign, right upper quadrant tenderness/mass/pain/rebound) had a sufficiently low negati…