Frequency of symptoms associated with gallstone disease: a hospital-based cross sectional study

Comparing the Sensitivity and Specificity of Computed Tomography and Ultrasound in the Diagnosis of Acute Cholecystitis in a Rural Setting

Background Acute cholecystitis (AC) is a common inflammatory disease of the gallbladder, primarily caused by gallstones or sludge blockage. Early diagnosis and treatment are crucial for reducing morbidity and mortality. Ultrasound (US) and computed tomography (CT) are commonly used imaging methods, with US being considered the gold standard. However, recent studies have shown that CT has higher sensitivity and specificity for diagnosing AC in large hospital settings. Objective This study aims to determine the sensitivity and specificity of US and CT for AC in a community hospital and to assess the sensitivity and specificity of specific signs seen on US and CT for AC. Methods A retrospective cohort study was conducted, including patients who underwent US of the right upper quadrant (RUQ) and/or CT of the abdomen and pelvis, followed by pathological evaluation of the gallbladder after surgical removal between May 1, 2019, and April 30, 2023. Data collected included patient demographics, laboratory values, symptoms, US findings, CT findings, and pathology results. Imaging signs were recorded based on radiology reports and were considered positive if any sign was present. A true positive for CT and US was recorded if imaging was positive for AC and the pathological report confirmed AC. Results A total of 187 patients who underwent cholecystectomy for AC, with a median age of 60.6 years, were included in the final analysis. Abdominal pain was the most common presenting symptom (176/187, 94.1%), followed by nausea (114/187, 61.0%) and vomiting (75/187, 40.1%). White blood cell (WBC) counts were elevated in all groups, with median levels of 11.3 (US only), 15.8 (CT only), and 12.3 (both US and CT) (p<0.001). Most patients (169/187, 90.4%) received an RUQ US, and 123/187 (65.8%) underwent a CT scan prior to surgery. The sensitivity of US and CT was found to be similar (98.6% and 93.4%, respectively) when following a one-sign criterion. US was more sensitive than CT (80.9% and 70.0%, respectively) when a two-sign criterion was used. In a direct comparison between CT and US, US was more sensitive in detecting cholelithiasis and a thickened gallbladder wall (95.9% and 92.3%, respectively), while CT was more sensitive in detecting pericholecystic fluid and gallbladder distension (83.6% and 95.7%, respectively). Conclusion In a community emergency department, US had higher sensitivity than CT for detecting AC when a two-sign criterion was used. Based on these results, US should continue to be the first-line imaging modality in patients suspected of having AC.

An epidemiological investigation of gallstone disease among patients admitted to Shahid Rahimi teaching hospital in Khorramabad in 2016-2020

Background

Gallstones are a significant global health issue, imposing enormous costs to patients and the healthcare system, annually.

Objectives

This epidemiological study aimed to explore the prevalence of gallstones among inpatients who were admitted to Shahid Rahimi Hospital in Khorramabad City, Iran, from 2016 to 2020.

Methods

This was a retrospective and descriptive-analytical study. The study population included patients who were admitted to Shahid Rahimi Hospital in Khorramabad City, Iran, who underwent abdominal ultrasounds from 2016 to 2020. The required data were collected using a checklist and patients' records. The logistic regression analysis method was used to analyse the obtained data in SPSS at the significance level of P<0.05.

Results

Of the 927 explored subjects, 232(25%) presented gallstones. The mean age of the patients with gallstones was 62.9 years. The most frequent symptom in individuals with gallstones was right upper quadriceps abdominal pain (63%). There was a significant relationship between gallstone and age, gender, epigastric pain, upper quadrant pain, hypertension, anemia, and family history.

Conclusion

The present study findings indicated that increasing age, female gender, the lack of epigastric pain, upper quadrant pain, anemia, hypertension, and a family history of this disease increased the risk of generating gallstone disease.

EJTM3 is also covering Mobility and Medicine at large, an update

Since the first 2018 issue, the European Journal of Translational Myology expanded its authorship and readership from the strict topics of biology, physiology, diagnostic, management and rehabilitation of skeletal muscle to the more clinically relevant fields of human mobility to those of general medicine. This third issue opens with a review on Chronic Fatigue Syndrome, a very complex medical problem, as its other names testify (Myalgic Encephalomyelitis or Systemic Exertion Intolerance Disease). A more typical molecular myology original article follows (Increasing autophagy does not affect neurogenic muscle atrophy), but then several Rapid Reports cover different Medical Specialties fields, related or unrelated to neuromyology, mobility problems and their potential solutions. The Advisors of EJTM invite Authors to submit typescripts, taking into account that the journal is keen to publish high-level papers in the fields of Translational Myology, Mobility and Medicine at large.

Implementing EjtM3 (European Journal of Translational Myology, Mobility, Medicine) along the silk-road

Two main novelties will appear in the second 2018 Issue of the European Journal of Translational Myology demonstrating that the journal is vital and in expansion, one novelty is that the journal is implementing its authorship and readership to broader clinical fields from muscle myology and mobility to clinical medicine and surgery. Consequently, the Editorial Board is also expanding to allow a broader expert evaluation of Authors submitted typescripts. The expanded Editorial Board recently evaluated the option to change the name of the journal from Ejtm to EjtM3 (Myology, Mobility, Medicine), in order to expand the original journal title meaning. Another important novelty is the first BAM Seminal Paper by Damraurer et al. 18(5): 139-148, 2008. It is now reprinted (with Basic and Applied Myology permission) in this Ejtm 28(2), 2018. The topic (chemotherapy-induced muscle wasting) was up-dated by one of our Editors stressing the relevance of the BAM 2008 paper to focus attention not only of myologists, but also of oncologists. From 2008, BAM (renamed from 2010 European Journal of Translational Myology) went far beyond the limits of pure Myology. Al last, but hopefully not at least, a series of Rapid Reports from Iranian Authors are paving the pathway Venetia-extreme Orient, along the ancient silk-road. Ejtm will enthusiastically publish clinical activities from surrounding and extreme Orient. The Marco Polo tradition and his bravery seem successfully continuing.