Point-of-care ultrasound for the evaluation of the infected pancreatic pseudocyst.

A 53-year-old man with a longstanding history of alcohol abuse presented to the Emergency Department with 3 days of worsening left upper quadrant abdominal pain, fever, and vomiting. He had noted increased left upper abdominal ‘‘swelling’’ over 1 month. The patient was febrile (38.7 C/101.7 F) and tachycardic (heart rate 112 beats/min), with otherwise normal vital signs. He had a large palpable mass in his left upper quadrant on physical examination. Laboratory assessments were significant for an elevated white blood cell count of 13,600/mm. His liver enzymes and lipase were unremarkable. A focused bedside ultrasound of the left upper quadrant was performed that identified a large heterogeneous cystic mass (Figure 1). A computed tomography (CT) scan of the abdomen with intravenous contrast revealed two large, walled-off fluid collections (Figures 2, 3).