Imaging Modality for Acute Cholecystitis due to Gallstones - Essay Example

Imaging Modality for Acute Cholecystitis due to Gallstones Introduction Defined as collection, analysis, modification, duplication, and visualization of images, imagining has remained an interesting filed of study due to the present technological advancement. It is an extensive filed that deals in association to computer science, computer vision, electrical engineering, mathematics, physics, and perceptual psychology. Creation of a visual image is a controversial issue in the society that poses impact on the health of an individual (Goroll & Mulley, 2009:550). The science of image creation has a range of links that include the human visual system, the capture device, subject of the image, the processor, and the display. All these need consideration when producing an image. Scientists have lately focused on the development and application of new diagnostic techniques that are beneficial to individuals based on the use of optical technologies such as lasers (Day, Paul, & Williams, 2009:1271). This paper gives an in depth discussion and justification of the choice of imaging modality for a woman in the third trimester of pregnancy with acute cholecystitis due to gallstones. Arguably, imaging has played a significant role in the management of patients whether hospitalized or not. Imaging modalities are available in health units according to patient population and clinical problems. To get a better understanding on which modality to use, several factors such as the method of generating the image, strengths and weaknesses, costs, and the associated risks of the practice need emphasis. Although excess exposure of imaging has pessimistic impacts on an individual’s health, imaging remains the widely used technologies in treatment. With imaging devices, a doctor is able to diagnose diseases and administer the required medication to the patient. Imaging devices used in healthcare units show variation in structure and use (Kleinman, 2008:1178). However, all of them are used for the well-being of the patient to ensure that the patient receives effective treatment. In a situation where a pregnant woman experiences cholecystitis, it is advisable that the woman receives immediate medical care. It is evident from research that management of this disease to pregnant women remains a controversial issue (Sajatovic and Loue, 2004:272). In most cases, a pregnant woman may be at risk of developing gallstones due to multiplicity and abnormal gallbladder motility. For instance, symptomatic cholecystitis is the second most common nongynecologic condition that requires survey in pregnant women. This disease occurs when there is prolonged obstruction of the cystic duct resulting to inflammation of the gallbladder wall (Leppert & Peipert, 2003:443). Medical research depicts that almost 20% of the patients with biliary colic left untreated, end up having acute cholecystitis. This disease tends to cause many fetal deaths due to its delayed surgical intervention. Treatment of this disease is very challenging due to its diagnosis and the reluctance of operating necessarily on a pregnant woman. However, it is important to note that early diagnosis and surgical intervention helps in prevention of fetal loss. Presently, cases of acute cholecystitis are diminishing due to the approval of laparoscopic cholecystectomy patients as a treatment of symptomatic gallstones. The disgram below shows a case of acute cholecystitis diagnosed through ultrasound. Through the ultrasound modality, thick wall of GB, stones in GB, and air in GB are shown. [image online] Available at: http://www.meddean.luc.edu/lumen/meded/Radio/curriculum/Harrisons/GI/Cholecystitis1a.jpg [Accessed 30 March 2012] Ultrasound modality Technological advancement has contributed to the introduction of several modalities. According to scholars, many of these modalities have side effects but they are inevitable. This is because these modalities use radiation whose exposure has drawn scholarly interest. However, I consider ultrasound the most effective modality. Why ultrasound is most preferable is due to lack of ionizing radiation. In addition, its multiplanar capability give is another advantage. As a result, ultrasound radiation has been presently chosen as the diagnostic modality in pregnant women due to its effectiveness, accuracy, speed, and noninvasiveness. It effectively produces good views of the gall bladder and detects all gallstones present at a sensitivity of 95%. Although patients get this treatment while in the third trimester, it is advisable that the radiologist diagnoses the patient early enough during the second trimester and the patient treated. This becomes the safest time for both the inborn child and the mother. For instance, it is during the second trimester when a woman is at low risk of miscarriage, teratogenesis, and preterm delivery (Fischer, Bland & Callery, 2007:1020). During the third trimester, the gravid uterus makes laparoscopy difficult by obscuring the operative field. The diagram below show the two main sections of a Ultrasound modality, which are the analog and the digital. [image online] Available at: http://www.electronicproducts.com/images2/facd_MindTree_aug2009_fig1.gif [Accessed 30 March 2012] Ultrasound imaging used for detecting acute cholecystitis and gallstones has not been shown to have many biological effects on the fetus during the third trimester though it is advisable to avoid its use during the first trimester. Ultrasound is the first line examination imaging technology for maternal abdominal trauma portrays efficiency and accuracy. It is specifically used to pregnancy situations and may end up being less useful for confirming pyelonephritis or most hepatic diseases. During the third trimester of pregnancy, pregnancy cause many complication. It is important to carry an ultrasound, whose image shows intrauterine fluid and debris as shown below [image online] Available at: http://img.medscape.com/pi/features/slideshow-slide/abdominal-pain/fig1.jpg [Accessed 30 March 2012] Ultrasound in many cases provides high specificity for gallstones that seem as tiny as less than two millimeters. Additionally, it is the first-line imaging modality for renal colic in pregnant women. In view of the fact that ultrasound is very specific to pregnancy, it is able to rule out alternative hepatic or bile duct pathologies suspected in pregnancy. Ultrasound radiations therefore portray importance in treatment for pregnant women (Ribes, et.al. 2008:233). Although this radiation has optimistic impacts on the patient and the fetus, pregnant women need to avoid the use of other imaging radiations since they can pose harmful impacts on the fetus. Ultrasound imaging is highly recommended by many people since it does not use any ionizing radiations. Moreover, this scanning procedure provides a comprehensible view of the soft tissues that are not clearly evidenced when using X-ray images. Moreover, ultrasound imaging is widely available, easy-to-use and less expensive compared to other imaging methods (Ribes, et.al. 2008:235). According to its efficiency, it minimizes invasive procedures such as needle aspiration and needle biopsies. Scholarly research depicts that ultrasound diagnosis shows no harmful effects on pregnant women. Through Ultrasound, it possible to trace blood flow through veins and arteries hence disorders in abnormal blood flow can be detected. Ovarian torsion is associated to the abnormality hence the need for fetal ultrasound. This is evident in the diagram below which shows fetal ultrasound examination carried out during the second to third trimester. [fetal ultrasound examination] [image online] Available at: [Accessed 30 March 2012] Ultrasound examinations are often easy and painless. For instance, a radiologist applies some warm water-based gel on the skin upon the area of examination and a transducer is moved back and forth over the area until desired images are obtained. The gel prevents and eliminates air pockets between the skin and the transducer that may hinder sound from passing through the body. Minor pains from the transducer and pressure may be felt in an area of tenderness. This imaging procedure lacks associated problems with pregnant women and hence a very convenient procedure. Although ultrasound is depicted as obviously the initial study of choice in diagnosing acute cholecystitis due to its accuracy, it comes along with limitations. Cases arise of presence of bowel gas and overlying soft tissues that hinder evaluation. In addition, patients with greater amounts of tissue attenuates are more difficult to image while using ultrasound. This is because the large amounts of tissues weaken the sounds as they penetrate deep into the body. In this case, Magnetic Resonance Imaging may be used to provide further information. This substitute modality most effectively reveals findings of biliary obstruction. MRI examination is depicted to lack iodine hence less likely to cause side effects or allergic reactions. Although MRI is efficient in detecting presence of gallstones in pregnant women, it has risks that have to be taken into consideration. For instance, the magnetic forces may have negative impacts on the inborn child. Therefore, this method of imaging depicts efficiency only on very important problems and circumstances or suspected abnormalities (Bluth, 2000:16). MRI examination takes duration of approximately15-45 minutes and thus the process does not take long. The procedure might be noisy while certain scanners operate and therefore it is advisable for an individual to wear earplugs or headphones to protect the ears. During the process, a saline solution drips through an intravenous line placed in an arm to prevent clotting. This takes place until a contrast agent called gadolinium is injected at some point during the examination to help obtain a clearer picture of the area being examined (Jones, 2004:744). During the examination, an individual remains motionless although some movements are necessary at some point. It is advisable for the pregnant woman to consult the scanner for any questions or discomfort. The procedure is safe for the baby and the mother and therefore may be recommended in cases where ultrasound imaging is unavailable. Conclusion In recapitulation, ultrasound imaging is an advisable modality to use to pregnant patient in the third trimester. As justified in this paper, its competence, accuracy, speed, lack of ionizing radiation, and its minimal effect to both the mother and the fetus give it the competitive advantage. Therefore, it is recommended for any patient experiencing acute cholecystitis to receive immediate medical assistance for the well-being of inborn child and too the mother (Kleinman, 2008:1179). The paper has also discussed on the importance of avoiding ionizing radiations since they can be of pessimistic impact to the fetus. High frequencies of fetus exposure to radiation, may lead to fetal death. It is the responsibility of the doctors to ensure that pregnant women are not exposed to the harmful radiations despite their pressure to be exposed. The inborn child has a right to live and the society contributes to a large part of it. Some women do not understand of the harmful impacts of these radiations. It is the responsibility of the society to educate them and make them knowledgeable before conducting any decision making pertaining going for frequent diagnosis. This will help in reduction of fetal deaths and maternal complications. Bibliography Bluth, I. E. 2000. Ultrasound: a practical approach to clinical problems. Boston: Thieme. Day, A. R., Paul, P. & Williams, B. 2009. Brunnar and Suddarths textbook of Canadian medical-surgical nursing. New York: Lippincott Williams & Wilkins. Fischer, E. J., Bland, I. K. & Callery, P. M. 2007. Mastery of surgery, Volume 2. New York: Lippincott Williams & Wilkins. Goroll, H. A. & Mulley, G. A. 2009. Primary care medicine: office evaluation and management of the adult patient. New York: Lippincott Williams & Wilkins. Jones, R. 2004. Oxford Textbook of Primary Medical Care: Clinical management. New York: Oxford University Press. Kleinman, E. R. 2008. Walkers Pediatric Gastrointestinal Disease: Physiology, Diagnosis, Management. New York: PMPH-USA. Leppert, C. P. & Peipert, F. J. 2003. Primary care for women. New York: Lippincott Williams & Wilkins. Ribes, R. et.al. 2008. Learning diagnostic imaging: 100 essential cases. New York: Springer. Sajatovic, M. and Loue, S. 2004. Encyclopedia of womens health. New York: Springer. Health Guide. 2012. The New York Times. Accessed from http://health.nytimes.com/health/guides/disease/gallstones/diagnosis.html Pregnancy Ultrasound. 2012. Available from http://www.pregnancy-info.net/pregnancy_ultrasound.html. [Accessed on March 29, 2012] Read More