5 parulekar sg ultrasound evaluation of common bile

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5. Parulekar SG. Ultrasound evaluation of common bile duct size. Radiology 1979; 133 : 703–7. 6. MacDonald FR, Cooperberg PL, Cohen MM. The WES triad: a specific sonographic sign of gallstones in the contracted gallbladder. Gastrointest Radiol 1981; 6 : 39–41. 7. Johnston DE, Kaplan MM. Pathogenesis and treatment of gallstones. N Engl J Med 1993; 328 : 412–21. 8. Summers SM, Scruggs W, Menchine MD, et al. A prospective evaluation of emergency department bedside ultrasonography for the detection of acute cholecystitis. Ann Emerg Med 2010; 56 : 114–22. 9. Blaquiere RM, Dewbury KC. The ultrasound diagnosis of emphysema- tous cholecystitis. Br J Radiol 1982; 55 : 114–16. 10. Durston W, Carl ML, Guerra W, et al. Comparison of quality and cost- effectiveness in the evaluation of symptomatic cholelithiasis with differ- ent approaches to ultrasound availability in the ED. Am J Emerg Med 2001; 19 : 260–9. 11. Kendall JL, Shimp RJ. Performance and interpretation of focused right upper quadrant ultrasound by emergency physicians. J Emerg Med 2001; 21 : 7–13. 12. Rosen CL, Brown DF, Chang Y, et al. Ultrasonography by emergency physicians in patients with suspected cholecystitis. Am J Emerg Med 2001; 19 : 32–6. 13. Blaivas M, Harwood RA, Lambert MJ. Decreasing length of stay with emergency ultrasound examination of the gallbladder. Acad Emerg Med 1999; 6 : 1020–3. 14. Gaspari RJ, Dickman E, Blehar D. Learning curve of bedside ultrasound of the gallbladder. J Emerg Med 2009; 37 : 51–6. Diagnostic ultrasound 171 Gallbladder ultrasound
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8 Ultrasound of the deep venous system Introduction Evaluation for deep vein thrombosis (DVT) can be one of the most useful exams for emergency and critical care physicians. There are approximately 250 000 new diagnoses of DVT and 50 000 deaths from thromboembolic disease annually [ 1 , 2 ]. The estimated rate of propagation from DVT to pul- monary embolism ranges from 10% to 50% [ 1 , 2 ]. Because the incidence of DVT is so high and because this disease is so prevalent in critical and acute care settings, the ability to rule in or rule out DVT at the bedside is a particularly powerful tool. The simplified compression technique described in this chapter evaluates for DVT at two anatomic sites of the lower extremity venous system. This protocol has been evaluated in multiple randomized controlled studies and has become a well-accepted protocol used for decision making in conjunction with clinical pretest probability assessments [ 3 –17]. Calf vein assessment is not described in this chapter. There exists some controversy over the clinical relevance of isolated calf vein DVT and the need to emergently assess for this entity [ 18 ]. Many radiology departments and vascular laboratories do not routinely assess for DVT distal to the popliteal vein. Proponents of whole-leg ultrasonography note that it can detect calf vein DVT and obviate the need for a follow-up study at a later point (which is the general recommendation after a normal two-point sonogram). Others point to the risks of anticoagulating a distal DVT whose natural clinical course has been demonstrated to be spontaneous resolution more than 50% of the time. In 2008, a randomized study of whole-leg sonography versus
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