- by Dr. Nigel Minihane, member of the Royal College of Physicians

Case

A 68-year-old man presented to his general practitioner with a 24-hour history of constant, centralised abdominal pain in the absence of pyrexia or other symptoms of sepsis.

On examination, he was tender in the right hypochondrium with no clinical evidence of liver enlargement.

Right subcostal POC Ultrasound nicely demonstrated the presence of a gallstone in a contracted gallbladder with an associated acoustic shadow.

The patient was able to return home with an oral antibiotic cover and will be referred for a surgical opinion.

Conclusion

The ability to rule in a suspected clinical diagnosis increases diagnostic accuracy for generalist physicians.