A 40s female presents with epigastric pain for two days, worse with meals. No fevers, but she’s had several episodes of non-bloody, non bilious emesis. POCUS biliary: A stone lodged in the neck of the gallbladder, the Stone-In-Neck phenomenon, has pretty good sensitivity and specificity for acute cholecystitis. Tip: Try rolling your patient from the supine to left lateral decubitus position, all the while keeping an eye on that stone the whole time. If it doesn’t budge despite patient repositioning, it’s likely lodged in the neck. More tips: Anecdotal, but if you’re not imaging the gallbladder with your patient in the left lateral decubitus position, give it a shot and let us know how it goes.
Stone In Neck [SIN] Phenomenon | Acute Cholecystitis | J Esteban Munoz Eusse & D Wiseman | Bronx NY
in Biliary