Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Common Bile Duct Stone on POCUS

Here’s a similar case in a 70yo F with a remote
, CBD also looks ... dilated, but there ... around in the CBD ... henneberry_ryan #Dilated ... #BileDuct #CBD
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Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis
Hepatocellular Pattern (ALT or AST > ALP):
Differential Diagnosis Algorithm ... (any) • US - Dilated ... Ducts - CBD ... stone, Biliary ... Transaminitis #Algorithm
Dilated Common Bile Duct on POCUS
50's yo patient with RUQ abd pain. Vitals stable/afebrile. Labs: WBC
patient with RUQ abd ... hepatic panel, normal ... no definitive stones ... mass in distal CBD ... #CBD #POCUS #ultrasound
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ERCP Management Algorithm for Patient with Symptomatic Choledocholithiasis 

Predictors of choledocholithiasis
Very strong
 - CBD stone on
Very strong - CBD ... stone on transabdominal ... dL Strong - Dilated ... CBD on US ( > 6 ... Moderate - Abnormal
Complex Hydronephrosis on Renal POCUS

Look beyond the RUSH exam - normal echo/flat IVC/no abd FF/no AAA....
Hydronephrosis on Renal POCUS ... the RUSH exam - normal ... echo/flat IVC/no abd ... Infected stone. ... Hydronephrosis #POCUS
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Intestinal Ultrasound (IUS) in IBD - IBD Algorithm

IUS Pros (+): no radiation, cost-effective, real-time data, well
Ultrasound (IUS) in IBD ... - IBD Algorithm ... Ultrasound #IUS #IBD ... #Algorithm #IBDAlgorithm ... #POCUS #gastroenterology
Dilated Distal Common Bile Duct on POCUS

Male with RUQ abdominal pain for 2 days.  GB
Pancreas/Distal CBD ... distal CBD. ... Answer: MULTIPLE stones ... in CBD(6+)(Yikes ... Common #BileDuct #CBD
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Cystic Duct Stone on Biliary POCUS

Not your average gall stone. This stone is lodged in the
Cystic Duct Stone ... on Biliary POCUS ... This stone is lodged ... CBD is also dilated ... #Biliary #POCUS
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2019 ASGE Update: Cholelithiasis - Risk of Choledocholithiasis and Management 

High Risk
 • CBD stone visualized
High Risk • CBD ... stone visualized ... bilirubin >4 mg/dL and dilated ... Medium Risk • Abnormal ... Age > 55 or • Dilated
Pediatric Trauma Primary Survey: C-ABCDE
C - Catastrophic Bleeding - Life-threatening hemorrhage
 • Apply direct pressure/compression bandage
Binder) • Use POCUS ... massive transfusion protocol ... Unilateral fixed and dilated ... shock - ↓HR, ↓BP, Abnormal ... tone, ↓ power