Point-of-Care Ultrasound Assisting in the Rapid Diagnosis of Acute Cholangitis 60 Years After Cholecystectomy.

BACKGROUND

Point-of-care ultrasound (POCUS) is used frequently to evaluate the right upper quadrant of patients with high suspicion for biliary pathology. In patients with a history of cholecystectomy, the utility of POCUS can be overlooked.

CASE REPORT: We report the case of an 83-year-old female patient who was ultimately diagnosed with cholangitis more than 60 years after undergoing cholecystectomy. POCUS demonstrated a dilated common bile duct (CBD), which was confirmed by computed tomography and magnetic resonance cholangiopancreatography to be due to a large stone. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Choledocholithiasis and cholangitis can still occur in patients with a remote history of cholecystectomy. POCUS can be used to rapidly evaluate the CBD for dilatation in patients post cholecystectomy.