The diagnostic and severity grading criteria on the 2018 Tokyo Guidelines (TG18) are used worldwide as the primary standard for management of acute cholangitis (AC). Continue reading
The changes improve the diagnosis of ARF among moderate/high-risk populations and re-establish the Jones criteria as the international gold standard for ARF diagnosis.
The Berlin definition, proposed in 2012, breaks with tradition by establishing three risk strata that are based on the degree of hypoxemia as assessed at a minimum positive end-expiratory pressure (PEEP).
Acute cholecystitis is a very common complication of cholelithiasis, and as such is frequently encountered in surgical practice. TG07 diagnostic criteria are recognized as those to be recommended in current care for acute cholecystitis.
The use of the Alvarado scoring system, which includes clinical examination findings and laboratory values, is helpful in ruling out appendicitis. Scores range from 1 to 10, with higher scores indicating a greater risk of appendicitis. When the score is less than 4, appendicitis is uncommon, and imaging and other interventions can be avoided.
Recently developed consensus functional definitions on the basis of specific changes in the serum creatinine concentration and urine volume now complement anatomical approaches to diagnosis.
Benign paroxysmal positional vertigo (BPPV) is characterized by brief spinning sensations, usually lasting less than 1 minute, which are generally induced by a change in head position with respect to gravity.
Recent guidelines published by the American College of Gastroenterology suggest that urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 hours after admission) is indicated in patients with biliary pancreatitis who have concurrent acute cholangitis, but it is not needed in most patients who do not have evidence of ongoing biliary obstruction.
Acute bacterial sinusitis in children is diagnosed on the basis of the history, with the use of the criteria. Imaging studies (plain-film radiography, computed tomography [CT], magnetic resonance imaging [MRI], and ultrasonography) show signs of sinus inflammation but are not recommended in patients with uncomplicated infection, given the low specificity of these studies.
Acute upper gastrointestinal (GI) bleeding is common and potentially life-threatening and needs a prompt assessment and aggressive medical management. All patients need to undergo endoscopy to diagnose, assess, and possibly treat any underlying lesion.