By Michael Prats, MD on 02/04/19 06:00 AM
The gallbladder loves to be scanned - a fluid filled sac nestled against a wonderful acoustic window? Are you kidding me? In any case, here is what we know: ultrasound is good for diagnosing cholecystitis, point of care ultrasound in the emergency department is good for diagnosing cholecystitis, BUT many surgeons still prefer a comprehensive RUQ ultrasound prior to cuttin' anyone. This article takes a look to see if these positive findings in the ED lead to people requiring cholecystectomy. Also - does it actually save time? https://www.ncbi.nlm.nih.gov/pubmed/30109274
By Michael Prats, MD on 12/10/18 06:00 AM
The FAST exam is tried and true for trauma, but in the past it hasn't been super useful for patients with isolated pelvic fractures. This study teases out a very sick subset of this population - patient who have significant hemorrhage associated with their fracture. The question is how well can the FAST identify intraabdominal hemorrhage in these people. The authors' idea is that if the FAST can find intraperitoneal blood, it might help determine who would benefit from REBOA instead of laparotomy.
By Michael Prats, MD on 11/12/18 06:00 AM
Ultrasound was made for the diagnosis of small bowel obstruction. It loves when air filled things are turned into fluid filled things - its helps us see it better. When the bowel gets backed up and distends with digested cheeseburgers, ultrasound is there to save the day. As easy as this may seem, it has not been well studied. There are a few small studies that show it can be accurate compared to a CT, but without a large body of evidence - a lot of people are (quite reasonably) unwilling to put their faith in it. Well, we can't say this study is going to turn all that around, but its one more piece of the puzzle of figuring out how we can use POCUS for this diagnosis.