[en] Background/Objectives: Ultrasonography is a diagnostic modality characterized by high sensitivity in detecting hepato-biliary pathology, particularly intrahepatic biliary duct dilation. This study compares the sonographic findings obtained by a radiographer/sonographer in a Basic Emergency Service (BES) using Point-of-Care Ultrasonography (POCUS) in Portugal with the sonographic findings from the same patients acquired by radiologists at a referral hospital (RH) for suspected intrahepatic biliary dilatation. Methods: Nineteen patients presenting with right upper quadrant (RUQ) pain and suspected abdominal pathology underwent sonographic screening using POCUS in the BES. Subsequently, the same patients were referred to the RH, where a radiologist performed a comprehensive ultrasound. Both examinations were compared to determine whether the findings obtained in the BES were confirmed by radiologists in the RH. Results: Cholestasis, cholangitis, lithiasis, pancreatitis, peri-ampullary lithiasis, and neoplasms were observed in association with intrahepatic biliary dilation in this study sample. All six variables showed a strong association between the BES and RH findings (Cramer’s V > 0.6; p < 0.006). A strong kappa measure of agreement between the radiographer and radiologist findings was obtained in “cholelithiasis/sludge/gallbladder acute sonographic changes” (k = 0.802; p = 0.000). A moderate kappa value was obtained for the variable “abdominal free fluid”, (k = 0.706; p = 0.001). Conclusions: In this study, all patients referred from the BES to the RH required hospitalization for treatment and additional imaging exams. Although pre-hospital screening ultrasound is not intended for definitive diagnoses, the early detection of intrahepatic biliary tract dilatation through screening sonography played a significant role in the clinical referral of patients, with a sensitivity of 94% and specificity of 75%.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Miravent, Sergio ; Basic Emergency Service of Vila Real de Santo Antonio, Algarve Local Health Unit, Vila Real de Santo António, Portugal ; Radiology Department, School of Health, University of Algarve, Faro, Portugal
Vaz, Bruna; Basic Emergency Service of Vila Real de Santo Antonio, Algarve Local Health Unit, Vila Real de Santo António, Portugal
Lobo, Manuel Duarte ; Escola Superior de Saúde Dr. Lopes Dias, Polytechnic University of Castelo Branco, Castelo Branco, Portugal
Jimenez, Cármen ; Basic Emergency Service of Vila Real de Santo Antonio, Algarve Local Health Unit, Vila Real de Santo António, Portugal
Pablo, Pedro; Levante Family Health Unit in Vila Real de Santo Antonio, Algarve Local Health Unit, Vila Real de Santo Antonio, Portugal
Figueiredo, Teresa; Faculty of Medicine and Biomedical Sciences, University of Algarve, Faro, Portugal
Barbancho, Narciso; Algarve Health Unit, Centro Hospitalar Universitário do Algarve, Faro, Portugal
Ventura, Miguel; Lendas de Olhão, Family Health Unit in Olhão, Algarve Local Health Unit, Olhão, Portugal
PEREIRA DE ALMEIDA, Rui Pedro ; University of Luxembourg > Faculty of Science, Technology and Medicine (FSTM) > Department of Health, Medicine and Life Sciences (DHML) > Medical Education
External co-authors :
yes
Language :
English
Title :
Point-of-Care Ultrasound for the Early Detection of Intrahepatic Biliary Tract Dilatation: A Local Study in a Basic Emergency Service
Publication date :
September 2025
Journal title :
Gastroenterology Insights
ISSN :
2036-7414
eISSN :
2036-7422
Publisher :
Multidisciplinary Digital Publishing Institute (MDPI)
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