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Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain

Enhanced computed tomography (CT) is widely used for evaluating acute biliary pain in the emergency department (ED). However, concern about radiation exposure from CT has also increased. We investigated the usefulness of pre-contrast CT for differential diagnosis in middle-aged subjects with suspect...

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Autores principales: Hwang, In Kyeom, Lee, Yoon Suk, Kim, Jaihwan, Lee, Yoon Jin, Park, Ji Hoon, Hwang, Jin-Hyeok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554168/
https://www.ncbi.nlm.nih.gov/pubmed/25700321
http://dx.doi.org/10.1097/MD.0000000000000546
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author Hwang, In Kyeom
Lee, Yoon Suk
Kim, Jaihwan
Lee, Yoon Jin
Park, Ji Hoon
Hwang, Jin-Hyeok
author_facet Hwang, In Kyeom
Lee, Yoon Suk
Kim, Jaihwan
Lee, Yoon Jin
Park, Ji Hoon
Hwang, Jin-Hyeok
author_sort Hwang, In Kyeom
collection PubMed
description Enhanced computed tomography (CT) is widely used for evaluating acute biliary pain in the emergency department (ED). However, concern about radiation exposure from CT has also increased. We investigated the usefulness of pre-contrast CT for differential diagnosis in middle-aged subjects with suspected biliary pain. A total of 183 subjects, who visited the ED for suspected biliary pain from January 2011 to December 2012, were included. Retrospectively, pre-contrast phase and multiphase CT findings were reviewed and the detection rate of findings suggesting disease requiring significant treatment by noncontrast CT (NCCT) was compared with cases detected by multiphase CT. Approximately 70% of total subjects had a significant condition, including 1 case of gallbladder cancer and 126 (68.8%) cases requiring intervention (122 biliary stone-related diseases, 3 liver abscesses, and 1 liver hemangioma). The rate of overlooking malignancy without contrast enhancement was calculated to be 0% to 1.5%. Biliary stones and liver space-occupying lesions were found equally on NCCT and multiphase CT. Calculated probable rates of overlooking acute cholecystitis and biliary obstruction were maximally 6.8% and 4.2% respectively. Incidental significant finding unrelated with pain consisted of 1 case of adrenal incidentaloma, which was also observed in NCCT. NCCT might be sufficient to detect life-threatening or significant disease requiring early treatment in young adults with biliary pain.
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spelling pubmed-45541682015-10-27 Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain Hwang, In Kyeom Lee, Yoon Suk Kim, Jaihwan Lee, Yoon Jin Park, Ji Hoon Hwang, Jin-Hyeok Medicine (Baltimore) 4500 Enhanced computed tomography (CT) is widely used for evaluating acute biliary pain in the emergency department (ED). However, concern about radiation exposure from CT has also increased. We investigated the usefulness of pre-contrast CT for differential diagnosis in middle-aged subjects with suspected biliary pain. A total of 183 subjects, who visited the ED for suspected biliary pain from January 2011 to December 2012, were included. Retrospectively, pre-contrast phase and multiphase CT findings were reviewed and the detection rate of findings suggesting disease requiring significant treatment by noncontrast CT (NCCT) was compared with cases detected by multiphase CT. Approximately 70% of total subjects had a significant condition, including 1 case of gallbladder cancer and 126 (68.8%) cases requiring intervention (122 biliary stone-related diseases, 3 liver abscesses, and 1 liver hemangioma). The rate of overlooking malignancy without contrast enhancement was calculated to be 0% to 1.5%. Biliary stones and liver space-occupying lesions were found equally on NCCT and multiphase CT. Calculated probable rates of overlooking acute cholecystitis and biliary obstruction were maximally 6.8% and 4.2% respectively. Incidental significant finding unrelated with pain consisted of 1 case of adrenal incidentaloma, which was also observed in NCCT. NCCT might be sufficient to detect life-threatening or significant disease requiring early treatment in young adults with biliary pain. Wolters Kluwer Health 2015-02-20 /pmc/articles/PMC4554168/ /pubmed/25700321 http://dx.doi.org/10.1097/MD.0000000000000546 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 4500
Hwang, In Kyeom
Lee, Yoon Suk
Kim, Jaihwan
Lee, Yoon Jin
Park, Ji Hoon
Hwang, Jin-Hyeok
Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain
title Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain
title_full Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain
title_fullStr Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain
title_full_unstemmed Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain
title_short Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain
title_sort do we really need additional contrast-enhanced abdominal computed tomography for differential diagnosis in triage of middle-aged subjects with suspected biliary pain
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554168/
https://www.ncbi.nlm.nih.gov/pubmed/25700321
http://dx.doi.org/10.1097/MD.0000000000000546
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