Diagnosis for Gallstones

Diagnosis for Gallstones

Gallstones are diagnosed either when there are symptoms that suggest gallstone, and the patient is being investigated for the diagnosis of gallstones or coincidentally while a non-gallstone-related medical problem is being evaluated. 

Ultrasound : Ultrasonography is the most important and valuable investigation for diagnosing gallstones. It confirms whether gallstones are present or not and can calculate their size. Ultrasound scans are painless, do not involve X-ray or use of radioactive materials, have no known damaging effects on the body and can be repeated safely as many times as needed. Abdominal ultrasound can identify many other abnormalities related to gallstones, like thickened wall of the gall bladder when there is cholecystitis, enlarged gall bladders, ducts and even pancreatitis. The limitations of ultrasonography are that it can only identify gallstones larger than 4-5 mm. in size, and it is poor at identifying gall stones in ducts. 

Oral Cholecystogram or Cholescintigraphy

An oral cholecystogram ( OCG) or cholescintigraphy involves receiving an injection of an iodine X-ray dye into a vein, or taking iodine-containing tablets for one or two nights in a row. X-rays are then taken of the gall bladder to see whether it contracts normally and stones are present. Though an excellent procedure for diagnosing gallstones, the OCG has been replaced by ultrasonography as the latter is better at diagnosing gallstones, can be done immediately and does not require exposure to X-rays. However, at times OCG detects gallstones that are missed by ultrsonography. For this reason, if there is a strong suspicion that gallstones are present but ultrsonography does not show them, it is reasonable to consider doing an OCG. 

CT Scan and MRI can also demonstrate gallstones. However, they are inferior to ultrsonography for the diagnosis of gallstones. 

Diagnosing Stones in the Common Bile Duct.

These tests are necessary in only a small percentage of people with gallstones. These are : 

ERCP : ERCP is a diagnostic procedure to examine the duodenum the bile ducts, the gall bladder and the pancreatic duct. The procedure is performed using a duodenoscope ( a type of endoscope). It involves passing a thin, flexible endoscope through the stomach and duodenum to the small intestine and into the bile duct. A special dye is released which stains the gall bladder's ducts. Any stones present in the ducts then can be seen on an X-ray. 

Other specialized diagnostic procedures are Percutaneous Transhepatic Cholangiography (PTC) and Magnetic Resonance Cholangio-Pancreatography (MRCP) 

Gallstones
Formation of Gallstones
Symptoms of Gallstones
Diagnosis for Gallstones
Treatment for Gallstones
Medications for Gallstones