Diagnosis of Gallstones
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Your doctor will ask about your symptoms, medical history, and risk factors. A physical exam will be done. Tests may include the following:
Imaging Studies
Abdominal ultrasound —Sound waves are used to produce an image of the gallbladder. This is usually the best test for diagnosing gallstones .
Abdominal x-ray (oral cholecystogram (OCG) or cholescintigraphy)—Pictures of the gallbladder are produced, and some gallstones can be identified this way. These are usually done after swallowing dye-containing pills, or receiving an injection of dye into a vein in the arm.
Abdominal computed tomography (CT) scan —X-ray images are taken from many different angles, and a computer puts them together to form an image of the gallbladder.
Hepatobiliary (HIDA) scan—A radioactive dye is injected into the arm, and pictures are then taken of the gallbladder to determine if it is functioning properly.
Endoscopic retrograde cholangiopancreatography (ERCP)—After you are sedated, a small tube (endoscope) is inserted through the mouth past the stomach and into the small intestine (duodenum). A contrast solution is then injected into the bile ducts and gallbladder. X-rays are taken, which can identify gallstones, tumors, or narrowing in the bile ducts.
Blood Tests
Liver Function Tests—Certain blood tests may help doctors evaluate whether the liver and pancreas are functioning properly, and if your symptoms are caused by a condition other than gallstones. These blood tests may include:
- Bilirubin
- Aspartate aminotransferase (AST)
- Alanine aminotransferase (ALT)
- Alkaline phosphatase (AP)
- Gamma glutamyl transpeptidase (GGT)
- Amylase
- Lipase
References:
Adler DG, Baron TH, Davila RE, et al. ASGE guideline: the role of ERCP in diseases of the biliary tract and the pancreas. Gastrointest Endosc. 2005;62:1-8.
Ahmed A, Cheung RC, Keefe EB. Management of gallstones and their complications. Am Fam Physician. 2000;61:1673-1678.
Beers MH, Berkow R. The Merck Manual. 18th ed. West Point, PA: Merck and Co; 2006.
Gallstones. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase . Accessed December 19, 2005.
Gallstones. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/gallstones/DS00165 . Accessed January 3, 2006.
Gallstones. Medline Plus Medical Encyclopedia website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000273.htm . Accessed January 3, 2006.
Gallstones. National Digestive Diseases Information Clearinghouse (NDDIC) website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gallstones/ . Accessed January 3, 2006.
Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet. 2006;368:230-239.
Last reviewed June 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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