The Case of the Radiolucent Gallstones

(This post was first published on blog.5minsono.com on August 17, 2016)

This week I’m joined by Jess Mason of EMRAP HD and This Won’t Hurt a Bit, two podcasts that if you haven’t subscribed to yet, you must!

We talk about a case where the CT scan missed a veritable hacksack of gallstones within the RUQ.

Enjoy!

  1. Great case Jacob !!
    Was wondering about the comment you made about the 10% mortality rate in elderly with abd pain..
    Do you have the reference ? My guess would be that in almost all of these cases ultrasound would get you the diagnosis or at least get a positive scan to send you in the right direction. Thereby avoiding lots of radiation.
    Where I work ( Netherlands) an ultraound like you showed in the case would be the definitive test , no CT needed. Would you agree ?

    Love to hear your thoughts!

    Vincent

    1. Yes, I would tend to agree. In this particular case, if I had been able to get the US before the CT I may not have gotten the CT scan. I work with residents (not all of them EM), and the CT scan was surprisingly done faster than I could see the patient. Here’s the reference regarding the 10% mortality rate: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306086/#B1. It quotes an older study, but I’ve seen that 10% mortality rate mentioned a bit. If you find a more recent one, I’d love to hear it!

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