Diagnosis of Gallstones
You will be asked about your symptoms and medical history. A physical exam will be done.
Tests may include:
—These tests may be used to find an infection,
, or an obstruction. For example, if bile flow is blocked, the bile will back up into the liver, which can be detected. Common tests include liver function tests, lipase, and amylase.
—A device will be held over the abdomen. It will bounce sound waves off the organs and the stones. The sound waves make electrical impulses that create a picture of the organ on a video monitor.
Endoscopic ultrasound—A long, flexible, lighted tube is inserted via the mouth or the rectum to visualize the different parts of digestive tract. A small ultrasound transducer is installed at the tip of the endoscope, which allows the doctor to get the device much closer to the internal organs of the body. This helps to obtain pictures of better quality and accuracy than those obtained through traditional ultrasound.
Cholecystogram—You will be asked to swallow some tablets containing contrast material. The contrast material is then absorbed into bile, which fills the gallbladder. X-rays are then taken. The x-rays can show movement of the gallbladder, presence of gallstones, and any blockage of the bile ducts.
Endoscopic retrograde cholangiopancreatography (ERCP)
—An endoscope is a long, flexible, lighted tube connected to a computer and monitor. The tube is guided through the stomach and into the small intestine. Dye is injected that stains the ducts in the biliary system. When the stones are located, they can also be removed. This method is effective for stones that have entered the common bile duct.
Cholescintigraphy—This test can be used to diagnose abnormal contractions of the gallbladder. You will receive an injection of a medication that includes radioisotopes, which are taken up in the gallbladder. The gallbladder is then stimulated to contract and is evaluated by a doctor using an x-ray procedure.
Magnetic resonance cholangiopancreatography (MRCP)—This is an imaging technique using MRI to let the doctor see the biliary and pancreatic ducts. Its purpose is to determine if there is a gallstone blocking any of these ducts. The test allows doctors to visualize the gall bladder, pancreas, and biliary ducts without the use of contrast dye, invasive procedures, or radiation exposure.
HIDA scan—This is an imaging test to check the function of the gallbladder. You will receive a tracer drug, which is taken up by the gallbladder. This test will help your doctor determine if the organ is functioning properly and the kind of disease you may have.
—This is an imaging test used to visualize the gall bladder, pancreas, and biliary ducts, but with contrast dye and radiation exposure.
Adler DG, Baron TH, et al. ASGE guideline: the role of ERCP in diseases of the biliary tract and the pancreas.
Ahmed A, Cheung RC, et al. Management of gallstones and their complications.
Am Fam Physician.
Gallstones. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 23, 2013. Accessed December 5, 2013.
Portincasa P, Moschetta A, et al. Gallstone disease: Symptoms and diagnosis of gallbladder stones.
Best Pract Res Clin Gastroenterol.
Portincasa P, Moschetta A, et al. Cholesterol gallstone disease.