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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

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Author(s)
In Kyeom HwangYoon Suk LeeJaihwan KimYoon Jin LeeJi Hoon ParkJin-Hyeok Hwang
Keimyung Author(s)
Lee, Yoon Suk
Department
Dept. of Internal Medicine (내과학)
Journal Title
Medicine
Issued Date
2015
Volume
94
Issue
7
Abstract
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.
(Medicine 94(7):e546)
Keimyung Author(s)(Kor)
이윤석
Publisher
School of Medicine
Citation
In Kyeom Hwang et al. (2015). Do We Really Need Additional Contrast-Enhanced Abdominal Computed Tomography for Differential Diagnosis in Triage of Middle-Aged Subjects With Suspected Biliary Pain. Medicine, 94(7), e546(1-6). doi: 10.1097/MD.0000000000000546
Type
Article
ISSN
0025-7974
DOI
10.1097/MD.0000000000000546
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33420
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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