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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:479-496 • 0278-4297

Image Presentation

Emergent Right Upper Quadrant Sonography

Susanna C. Spence, MD, Davis Teichgraeber, MD and Chitra Chandrasekhar, MD

Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center, Houston, Texas USA.

Address correspondence to Chitra Chandrasekhar, MD, Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center, 5656 Kelley St, Houston, TX 77026 USA. E-mail: chitra.chandrasekhar{at}uth.tmc.edu

Objective. The purpose of this presentation is to review the sonographic spectrum of disease entities evaluated by right upper quadrant (RUQ) sonography on an emergent basis. Methods. Right upper quadrant sonography was performed on an emergent basis in patients who came to the emergency department with signs and symptoms suspicious for or simulating acute cholecystitis or diseases of the liver and biliary tree. Results. A wide gamut of acute and chronic cholecystitis and diseases of the liver and biliary tree were visualized on RUQ sonography. Several other entities in addition to hepatic and biliary disease were also suspected on sonography and further evaluated by computed tomography. Conclusions. Right upper quadrant sonography is the first line of imaging in patients with signs and symptoms of hepatic, gallbladder, or biliary disease as well as RUQ pain. Patient triage or additional imaging may be obtained on the basis of emergent RUQ sonographic findings.

Key Words: biliary dilatation • cholecystitis • gallbladder • liver • pancreatitis

Abbreviations: CT, computed tomography • HIV, human immunodeficiency virus • IVC, inferior vena cava • RUQ, right upper quadrant

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