Why Gallbladder Disease is often missed
Updated: Dec 2, 2020
I enjoy attending business networking events because it gives me the opportunity to tell fellow attendees about nuclear medicine and it's importance in diagnosis and treatment of medical conditions. Usually when I first introduce myself as a nuclear medicine imaging professional, I get a stare that makes it clear for the most part that they have no idea exactly what I do. I love to see the change in facial expressions and keen interest as soon as I begin to connect nuclear medicine procedures to the diagnosis of common ailments or symptoms that they, their loved ones or someone they know has experienced or visited the emergency room for.
During one of such events recently, one of my table members became very interested when I mentioned HIDA scan for gallbladder disease. Unfortunately, a member of her family has repeatedly visited multiple emergency rooms for abdominal pain over the past few years and is yet to find a resolution. This is actually commonly reported by patients as seen in this article published by one such patient in Healthline. Abdominal pain is one of the top reasons people visit the emergency room. According to an April 2019 article published by Definitive Healthcare titled "Top 20 most common ER diagnoses", unspecified abdominal pain was the 5th most common diagnoses and accounted for 1,300,583 of ER visits in the United States for the year 2017. Depending on the location of the pain, there are multiple possible resulting diagnoses, some of which are life-threatening.
Unspecified abdominal pain was the 5th most common diagnoses and accounted for 1,300,583 of ER visits in the United States for the year 2017.
For the most part, patients who visit the Emergency room for abdominal pain routinely have ultrasound of the abdomen and sometimes a CT of the abdomen performed on them. Both ultrasound and CT scans are able to diagnose presence of gallstones (cholelithiasis), as well as the location, distribution and size of the stones. They can also detect if the gallbladder is thickened, inflamed (cholecystitis) or contains sludge. For patients who receive a positive diagnosis via ultrasound or CT, the path to resolving their complaints is much clearer.
On the other hand for patients who receive a negative (normal) abdominal ultrasound or CT report, their pain is managed and they are sent home. Majority of these patients end up returning to the emergency room with same complaint within weeks or even days of discharge. Many patients visit a different emergency room from the one they originally visited and so begin another round of testing, typically the same procedures as the ones performed during their earlier visit at another facility. For some patients, this cycle continues until an experienced emergency room or family physician orders a HIDA scan, a nuclear medicine scan that assesses gallbladder function.
On the other hand for patients who receive a negative (normal) abdominal ultrasound or CT report, their pain is managed and they are sent home. Majority of these patients end up returning to the emergency room with same complaint within weeks or even days of discharge.
Now that you know.........
Many times knowledge is what makes the difference when it comes to staying healthy or resolving our health challenges. If you or someone you know has visited the emergency room multiple times for abdominal pain without getting relief and have never had a HIDA scan performed, it's time to talk to a physician especially if you have a strong family history of gallbladdder disease. Knowledge is power!!
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