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Right Upper Quadrant (right + upper_quadrant)

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Medical Sciences100%

Terms modified by Right Upper Quadrant

  • right upper quadrant pain
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    Selected Abstracts

    Ultrasound Training for Emergency Physicians, A Prospective Study

    ACADEMIC EMERGENCY MEDICINE, Issue 9 2000
    Diku P. Mandavia MD
    Abstract. Objectives: Bedside ultrasound examination by emergency physicians (EPs) is being integrated into clinical emergency practice, yet minimum training requirements have not been well defined or evaluated. This study evaluated the accuracy of EP ultrasonography following a 16-hour introductory ultrasound course. Methods: In phase I of the study, a condensed 16-hour emergency ultrasound curriculum based on Society for Academic Emergency Medicine guidelines was administered to emergency medicine houseofficers, attending staff, medical students, and physician assistants over two days. Lectures with syllabus material were used to cover the following ultrasound topics in eight hours: basic physics, pelvis, right upper quadrant, renal, aorta, trauma, and echo-cardiography. In addition, each student received eight hours of hands-on ultrasound instruction over the two-day period. All participants in this curriculum received a standardized pretest and posttest that included 24 emergency ultrasound images for interpretation. These images included positive, negative, and nondiagnostic scans in each of the above clinical categories. In phase II of the study, ultrasound examinations performed by postgraduate-year-2 (PGY2) houseofficers over a ten-month period were examined and the standardized test was readministered. Results: In phase I, a total of 80 health professionals underwent standardized training and testing. The mean ± SD pretest score was 15.6 ± 4.2, 95% CI = 14.7 to 16.5 (65% of a maximum score of 24), and the mean ± SD posttest score was 20.2 ± 1.6, 95% CI = 19.8 to 20.6 (84%) (p < 0.05). In phase II, a total of 1,138 examinations were performed by 18 PGY2 houseofficers. Sensitivity was 92.4% (95% CI = 89% to 95%), specificity was 96.1% (95% CI = 94% to 98%), and overall accuracy was 94.6% (95% CI = 93% to 96%). The follow-up ultrasound written test showed continued good performance (20.7 ± 1.2, 95% CI = 20.0 to 21.4). Conclusions: Emergency physicians can be taught focused ultrasonography with a high degree of accuracy, and a 16-hour course serves as a good introductory foundation. [source]

    Supra-elevated CA 19-9 in a benign hepatic cystadenoma

    HPB, Issue 1 2004
    CR Scoggins
    Background Elevated CA 19-9 may be found in both cystadenomas and cystadenocarcinomas of the liver. Case outline A 59-year-old woman presented with right upper quadrant abdominal pain, malaise and weight loss. Physical examination and laboratory evaluation revealed a mass in the right upper quadrant and a CA 19-9 level of 68 661 U/ml. CT scan demonstrated a cystic liver mass. She underwent a right hepatectomy, and her CA 19-9 returned to normal. Pathologic analysis revealed no malignancy. Discussion In hepatic cystic neoplasms, an elevated CA 19-9 should not be used to establish the diagnosis of malignancy nor should it preclude resection. [source]

    Late-onset Papillon,Lefevre syndrome with pyogenic liver abscesses: report of one case

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2009
    Ameneh Yazdanfar MD
    A 25-year-old woman living in Hamedan, Iran, presented originally at 7 years of age with erythematous, hyperkeratotic lesions on the palms and soles with extension to the dorsal side of the hands and feet. Involvement of the elbows and knees was also seen. From 12 years of age, she started to lose her teeth. At the same age, she experienced fever, chills, malaise, myalgia, and right upper quadrant abdominal pain. With a diagnosis of pyogenic liver abscesses, the patient underwent successful surgical treatment. ,Examination revealed erythematous, hyperkeratotic, scaling plaques on the palms and soles, dorsal side of the hands and feet (Fig. 1), elbows and knees. All the teeth were missing from the mouth (Fig. 2), and she used a dental prosthesis. A surgical scar was observed on the right upper quadrant of the abdomen (Fig. 3). Skull X-ray and computed tomography scan were normal. Skin biopsy of the dorsal right hand demonstrated hyperkeratosis, focal parakeratosis, hypergranulosis, and acanthosis with a mild inflammatory infiltrate around the vessels (Fig. 4). Figure 1. Hyperkeratotic plaques on the hands and feet Figure 2. Loss of permanent teeth Figure 3. Surgical scar on the right upper quadrant of the abdomen and hyperkeratotic plaques on the hand Figure 4. Hyperkeratosis, focal parakeratosis, hypergranulosis, and acanthosis (hematoxylin and eosin, ×40) [source]

    Liver test patterns in patients with acute calculous cholecystitis and/or choledocholithiasis

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2009
    M. S. PADDA
    Summary Background, Liver tests are utilized to determine the presence of biliary obstruction. Aim, To examine our hypothesis that liver tests aid in elucidating whether patients have simple calculous cholecystitis (ACC) or choledocholithiasis (CDL). Methods, We performed a retrospective study of patients admitted to two University of Texas Southwestern teaching hospitals with a clinical picture consistent with ,acute gallstone disease', i.e. cholecystitis ± choledocolithiasis. The presence of ACC and CDL was based on defined clinical criteria. Results, The cohort consisted of 154 patients meeting specific entry criteria, primarily with right upper quadrant pain; 62 ACC, 79 both ACC and CDL and 13 CDL alone. Approximately 30% of patients with ACC had abnormal alkaline phosphatase (ALP) and/or bilirubin level and approximately 50% had abnormal aminotransferase levels. Among patients with ACC/CDL, 77% had abnormal ALP, 60% had abnormal bilirubin and 90% had abnormal aminotransferase levels. By multivariate analysis, increasing common bile duct size and an abnormal ALP and alanine aminotransferase (ALT) were excellent predictors of having ACC with CDL. Conclusions, Liver test patterns can aid in elucidating CDL, including in ACC patients. Fundamentally, patients with CDL were more likely to have more abnormal liver tests, whether they had CDL only, or CDL and ACC. A dilated CBD, and abnormal ALP and ALT had modest sensitivity and high specificity for identification of patients with ACC and CDL. [source]