Materiały źródłowe

• #1 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  Gallstones (cholelithiasis) are solid calculi formed by precipitation of supersaturated bile composed of cholesterol monohydrate crystals or by black pigment of polymerized calcium bilirubinate. […] In the United States, 6% of men and 9% of women have gallstones, most of which are asymptomatic. […] The characteristic symptoms of gallstones are episodic attacks of severe pain in the right upper abdominal quadrant (biliary colic) for at least 15-30 minutes, with radiation to the right back or shoulder and a positive reaction to analgesics. […] Acute cholecystitis should be suspected in a patient with fever, severe pain located in the right upper abdominal quadrant lasting for several hours, and right upper abdominal pain and tenderness on palpation (the Murphy sign). […] Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease; it is the most sensitive, specific, noninvasive, and inexpensive test for the detection of gallstones.

• #2 Biliary Colic and Cholecystitis – TeachMeSurgery

  https://teachmesurgery.com/hpb/gall-bladder/colic-and-cholecystitis/

  Gallstone disease is a common condition, affecting around 10-14% in Western populations. Most individuals with gallstones will remain asymptomatic, however on average 1-4% of individuals will develop symptoms secondary to their gallstones. […] Gallstones can cause a spectrum of disease, from biliary colic to acute pancreatitis, depending on the region of the biliary system involved. […] Studies have shown for those who are symptomatic, over 50% will present as biliary colic and 35% as an acute cholecystitis. […] Biliary colic occurs when the gallbladder neck becomes impacted by a gallstone. […] Patients with acute cholecystitis will report a constant pain in the RUQ or epigastrium, associated with signs of inflammation, such as fever or lethargy. […] A trans-abdominal ultrasound is one of the most sensitive modalities for visualising gallstone disease and is typically used first line to investigate suspected gallstone pathology. […] The gold standard investigation for gallstones is Magnetic Resonance Cholangiopancreatography (MRCP), largely replacing ERCP for diagnostic purposes. […] Most cases can be diagnosed by US abdomen scan. […] Definitive treatment for simple gallstone disease is via laparoscopic cholecystectomy.

• #3 Management of Gallstones and Their Complications | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0315/p1673.html

  The accurate differentiation of gallstone-induced biliary colic from other abdominal disease processes is the most crucial step in the successful management of gallstone disease. […] Despite the availability of many imaging techniques to demonstrate the presence of gallstones, clinical judgment ultimately determines the association of symptoms with cholelithiasis and its complications. […] In this article, we review the salient clinical features, diagnostic tests and therapeutic options employed in the management of gallstones and their complications. […] A wide array of laboratory and radiologic studies is used for the evaluation of gallstones located in the gallbladder and the common bile duct. […] Ultrasonography should be a routine examination for the confirmation or exclusion of gallstone disease.

• #4 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Patients with uncomplicated cholelithiasis or simple biliary colic typically have normal laboratory test results. Laboratory testing is generally not necessary unless cholecystitis is a concern. […] Asymptomatic gallstones are often found incidentally on plain radiographs, abdominal sonograms, or computed tomography (CT) scans for workup of other processes. […] In patients with suspected gallstone complications, blood tests should include a complete blood cell (CBC) count with differential, liver function panel, and amylase and lipase. […] Acute cholecystitis is associated with polymorphonuclear leukocytosis. […] Patients with cholangitis and pancreatitis have abnormal laboratory test values. Importantly, a single abnormal laboratory value does not confirm the diagnosis of choledocholithiasis, cholangitis, or pancreatitis; rather, a coherent set of laboratory studies leads to the correct diagnosis.

• #5 Diagnosis

  https://www2.hse.ie/conditions/gallstones/diagnosis/

  Gallstones are sometimes found during tests for different conditions. Gallstones often don’t cause any symptoms. […] If you do have symptoms of gallstones, make an appointment with your GP so they can try to identify the problem. […] Your GP will ask about your symptoms. They may carry out a test to find out if your gallbladder is inflamed. […] If you find this painful, it usually means you have an inflamed gallbladder. You may then need urgent treatment. […] Your GP may also recommend having blood tests. This is to look for signs of infection. The test will also check if your liver is working normally. If gallstones have moved into your bile duct, the liver may not be able to function properly. […] If your symptoms and test results show you may have gallstones, Your GP will refer you for further tests.

• #6 Gallstone – Wikipedia

  https://en.wikipedia.org/wiki/Gallstone

  Gallstones typically form in the gallbladder and may result in symptoms if they block the biliary system. […] Diagnostic method Based on symptoms, confirmed by ultrasound. […] Gallstones may be suspected based on symptoms. Diagnosis is then typically confirmed by ultrasound. […] Diagnosis is typically confirmed by abdominal ultrasound. Other imaging techniques used are ERCP and MRCP. Gallstone complications may be detected on blood tests. […] A positive Murphy’s sign is a common finding on physical examination during a gallbladder attack.

• #7 How to Test for Gallbladder Issues: Blood Tests and Imaging

  https://www.healthline.com/health/how-to-test-for-gallbladder-issues

  Doctors can test for gallbladder issues using a combination of physical exams, blood tests, and imaging studies. […] Lets explore how doctors use diagnostic tools like physical exams, ultrasounds, blood tests, and other imaging techniques to test for gallbladder issues, identify the underlying causes, and guide treatment. […] After taking a complete medical history, a physical examination is often the next step in diagnosing gallbladder problems. […] They may perform a test known as Murphys sign, which involves pressing on your abdomen while you take a deep breath. If this action causes sharp pain, it could indicate gallbladder inflammation. […] Additionally, your doctor will look for signs of jaundice, such as yellowing of the skin and eyes, which can suggest a bile duct blockage and indicate the presence of gallbladder disease.

• #8

  https://www.parkwayeast.com.sg/conditions-diseases/gallstones/diagnosis-treatment

  Your doctor will take a comprehensive history and do a thorough physical evaluation (e.g. check your eyes and skin for a yellowish tint that indicates jaundice, which is caused by too much bilirubin in your body). […] Diagnostic and imaging tests may also be recommended, which include: […] Ultrasound This allows the doctor to see into your abdomen and confirm the presence of gallstones. […] Abdominal CT scan This captures images of your liver and the abdominal region. […] Blood test This measures liver function and determines bilirubin levels and any signs of infection or inflammation. […] Magnetic retrograde cholangiopancreatography (MRCP) This is a specialised MRI scan of the region to assess the bile ducts to reveal if there are gallstones obstructing the bile ducts. […] Endoscopic retrograde cholangiopancreatography (ERCP) This is an endoscopic procedure that uses X-rays to reveal if gallstones may be obstructing your bile duct. This endoscopy can also be potentially therapeutic. For example, it can remove the common bile duct stone, deploy a stent to relieve jaundice, or treat bile duct infections. […] Gallbladder radionuclide scan, in which a radioactive dye is injected into the veins to check the gallbladders emptying function. It can also be used to look for bile duct blockage or leakage.

• #9 Making the Diagnosis of Gallbladder Disease

  https://www.verywellhealth.com/diagnosis-of-gallbladder-disease-4163874

  These associated symptoms can help a healthcare provider pinpoint whether gallbladder disease and other possible complications are present. […] The presence of jaundice, signaled by yellowing of the whites of the eyes and/or skin, is worrisome for a gallstone complication called choledocholithiasis in which a gallstone leaves the gallbladder and blocks the main bile duct (where bile flows into the intestines). […] If a diagnosis of gallbladder disease is not certain after an ultrasound, a HIDA scan may be performed. […] If the gallbladder cannot be visualized the test is „positive” because it means that there is some sort of obstruction (often from a gallstone, but possibly from a tumor) in the cystic duct, which is a tube that transports bile from the gallbladder to the common bile duct.

• #10 Gallstones | Symptoms, Causes & Treatment | Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/gallstones/

  Gallstones are small, solid lumps that form in bile. They usually cause no symptoms and most people with gallstones are unaware that they have them. However, in some people they can cause problems. […] If a person complains of pains anywhere around the top of the belly (abdomen), especially if these pains have been lingering for a few hours at a time and coming and going in waves, the doctor may suspect gallstones. The presence of jaundice adds to the likelihood of gallstones and should always be checked out thoroughly. A visual check for signs of jaundice would be carried out, and often blood tests would be sent away. In addition, the doctor will carry out a physical examination to determine whether there is soreness at the top of the abdomen. If these findings point to a diagnosis of gallstones, it is usual for the person with symptoms to be referred for further investigations. These can include: […] Ultrasound scan: This is where a small flat device is moved over the upper belly (abdomen) in the region of the liver and gallbladder. Most gallstones reflect ultrasound very well. […] If the ultrasound scan does not give a clear result, other tests may be needed such as a CT or MRI scan.

• #11 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Patients with uncomplicated cholelithiasis or simple biliary colic typically have normal laboratory test results. Laboratory testing is generally not necessary unless cholecystitis is a concern. […] Asymptomatic gallstones are often found incidentally on plain radiographs, abdominal sonograms, or computed tomography (CT) scans for workup of other processes. […] In patients with suspected gallstone complications, blood tests should include a complete blood cell (CBC) count with differential, liver function panel, and amylase and lipase. […] Acute cholecystitis is associated with polymorphonuclear leukocytosis. […] Patients with cholangitis and pancreatitis have abnormal laboratory test values. Importantly, a single abnormal laboratory value does not confirm the diagnosis of choledocholithiasis, cholangitis, or pancreatitis; rather, a coherent set of laboratory studies leads to the correct diagnosis.

• #12 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Patients with uncomplicated cholelithiasis or simple biliary colic typically have normal laboratory test results. Laboratory testing is generally not necessary unless cholecystitis is a concern. […] Asymptomatic gallstones are often found incidentally on plain radiographs, abdominal sonograms, or computed tomography (CT) scans for workup of other processes. […] In patients with suspected gallstone complications, blood tests should include a complete blood cell (CBC) count with differential, liver function panel, and amylase and lipase. […] Acute cholecystitis is associated with polymorphonuclear leukocytosis. […] Patients with cholangitis and pancreatitis have abnormal laboratory test values. Importantly, a single abnormal laboratory value does not confirm the diagnosis of choledocholithiasis, cholangitis, or pancreatitis; rather, a coherent set of laboratory studies leads to the correct diagnosis.

• #13 How to Test for Gallbladder Issues: Blood Tests and Imaging

  https://www.healthline.com/health/how-to-test-for-gallbladder-issues

  Blood tests can help doctors assess gallbladder function and detect possible infections or complications. […] Common tests include: […] A CBC detects infections or inflammation by checking white blood cell levels. […] These tests capture detailed images of the gallbladder and bile ducts, helping doctors test for gallbladder issues such as gallstones, inflammation, or blockages. […] A gallbladder ultrasound is often the first imaging test for gallbladder issues. […] This painless process helps detect gallstones, thickened gallbladder walls, or signs of inflammation. […] Doctors often use EUS to diagnose gallbladder abnormalities or stage tumors in the gallbladder, bile ducts, and pancreas. […] This test uses X-ray technology to create detailed cross-sectional images of the abdomen.

• #14 Gallstones – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-conditions/gallstones/

  Many people live with gallstones without symptoms and are unaware they have them until the stones show up in tests performed for another reason. […] If you have symptoms and gallstones are suspected, your GP will ask you about the symptoms you are experiencing and may feel your abdomen to see if your liver or gallbladder is tender or enlarged. Blood tests are usually the next tests that your GP will carry out. […] A sample of blood is taken by your doctor or a nurse and sent for analysis. These blood tests will look for signs of infection or inflammation. Additional blood tests known as liver function tests (LFTs) will also be done and will look for indications of inflammation, blockage of the bile ducts and damage to the liver. […] If you are found to have an abnormal result, or a strong clinical history (a family history of gallstones, previous gallbladder surgery or you have risk factors for gallstones), then your GP will refer you for further tests, such as an ultrasound scan, to confirm your diagnosis.

• #15

  https://www.parkwayeast.com.sg/conditions-diseases/gallstones/diagnosis-treatment

  Your doctor will take a comprehensive history and do a thorough physical evaluation (e.g. check your eyes and skin for a yellowish tint that indicates jaundice, which is caused by too much bilirubin in your body). […] Diagnostic and imaging tests may also be recommended, which include: […] Ultrasound This allows the doctor to see into your abdomen and confirm the presence of gallstones. […] Abdominal CT scan This captures images of your liver and the abdominal region. […] Blood test This measures liver function and determines bilirubin levels and any signs of infection or inflammation. […] Magnetic retrograde cholangiopancreatography (MRCP) This is a specialised MRI scan of the region to assess the bile ducts to reveal if there are gallstones obstructing the bile ducts. […] Endoscopic retrograde cholangiopancreatography (ERCP) This is an endoscopic procedure that uses X-rays to reveal if gallstones may be obstructing your bile duct. This endoscopy can also be potentially therapeutic. For example, it can remove the common bile duct stone, deploy a stent to relieve jaundice, or treat bile duct infections. […] Gallbladder radionuclide scan, in which a radioactive dye is injected into the veins to check the gallbladders emptying function. It can also be used to look for bile duct blockage or leakage.

• #16 Surgical and Nonsurgical Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0515/p795.html

  After an episode, physical examination findings are usually normal, with the possible exception of residual upper abdominal tenderness. […] Acute cholecystitis is an inflammation of the gallbladder caused by gallstones blocking the cystic duct. […] The recommended initial imaging study for most patients with suspected gallstones or a complication of gallstones is abdominal ultrasonography. […] Magnetic resonance cholangiopancreatography is a noninvasive study with high sensitivity and specificity for the detection of gallstones. […] Choledocholithiasis is found in 6% to 12% of patients with gallstones; it increases the risk of recurrent symptoms, pancreatitis, and cholangitis. […] Laboratory studies recommended for patients with suspected complications of gallstones include a complete blood count and measurement of hepatic transaminase, total bilirubin, alkaline phosphatase, amylase, and lipase levels.

• #17 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Patients with uncomplicated cholelithiasis or simple biliary colic typically have normal laboratory test results. Laboratory testing is generally not necessary unless cholecystitis is a concern. […] Asymptomatic gallstones are often found incidentally on plain radiographs, abdominal sonograms, or computed tomography (CT) scans for workup of other processes. […] In patients with suspected gallstone complications, blood tests should include a complete blood cell (CBC) count with differential, liver function panel, and amylase and lipase. […] Acute cholecystitis is associated with polymorphonuclear leukocytosis. […] Patients with cholangitis and pancreatitis have abnormal laboratory test values. Importantly, a single abnormal laboratory value does not confirm the diagnosis of choledocholithiasis, cholangitis, or pancreatitis; rather, a coherent set of laboratory studies leads to the correct diagnosis.

• #18 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Patients with uncomplicated cholelithiasis or simple biliary colic typically have normal laboratory test results. Laboratory testing is generally not necessary unless cholecystitis is a concern. […] Asymptomatic gallstones are often found incidentally on plain radiographs, abdominal sonograms, or computed tomography (CT) scans for workup of other processes. […] In patients with suspected gallstone complications, blood tests should include a complete blood cell (CBC) count with differential, liver function panel, and amylase and lipase. […] Acute cholecystitis is associated with polymorphonuclear leukocytosis. […] Patients with cholangitis and pancreatitis have abnormal laboratory test values. Importantly, a single abnormal laboratory value does not confirm the diagnosis of choledocholithiasis, cholangitis, or pancreatitis; rather, a coherent set of laboratory studies leads to the correct diagnosis.

• #19 Gallstones – Diagnosis and Treatment

  https://www.radiologyinfo.org/en/info/gallstones

  Your doctor may use abdominal CT, magnetic resonance cholangiopancreatography (MRCP), or abdominal ultrasound to help diagnose your condition. […] Imaging is used to provide your doctor with valuable information about gallstones, such as location, size and effect on organ function. […] Some types of imaging that your doctor may order include: Abdominal ultrasound: Ultrasound produces pictures of the gallbladder and bile ducts. It shows signs of inflammation or indications that there is blockage of bile flow. […] Abdominal CT: CT rapidly produces detailed pictures of the gallbladder and bile ducts to look for signs of inflammation or indications that there is blockage of bile flow. […] Magnetic resonance cholangiopancreatography (MRCP): MRCP is an MRI exam that produces detailed images of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. It identifies gallstones and can show gallbladder or bile duct inflammation or blockage.

• #20 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease; it is the most sensitive, specific, noninvasive, and inexpensive test for the detection of gallstones. […] Sensitivity is variable and dependent upon operator proficiency, but in general, it is highly sensitive and specific for gallstones greater than 2 mm. […] Ultrasonography is very useful for diagnosing uncomplicated acute cholecystitis. […] Common bile duct (CBD) stones are missed frequently on transabdominal ultrasonography (sensitivity, 15%-40%). […] Endoscopic ultrasound (EUS) is also an accurate and relatively noninvasive technique to identify stones in the distal common bile duct. […] Computed tomography (CT) scanning is more expensive and less sensitive than ultrasonography for the detection of gallbladder stones.

• #21 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  Although cholescintigraphy is recognized to have a higher sensitivity and specificity, US remains the initial test of choice for imaging patients with suspected acute cholecystitis (AC). […] Only 74-79% of gallstones are identified in patients with computed tomography (CT) scanning. […] Magnetic resonance imaging (MRI) is not a diagnostic screening tool for cholelithiasis. […] The ACR guidelines for evaluation of right upper quadrant pain include the following: Ultrasonography (US) is preferred as the initial imaging study for right upper quadrant pain, with supplemental cholescintigraphy performed when US results are equivocal. […] The European Association for the Study of the Liver (EASL) guidelines recommend that abdominal ultrasonography be used as the primary diagnostic imaging tool for suspected gallstones.

• #22 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  Gallstones (cholelithiasis) are solid calculi formed by precipitation of supersaturated bile composed of cholesterol monohydrate crystals or by black pigment of polymerized calcium bilirubinate. […] In the United States, 6% of men and 9% of women have gallstones, most of which are asymptomatic. […] The characteristic symptoms of gallstones are episodic attacks of severe pain in the right upper abdominal quadrant (biliary colic) for at least 15-30 minutes, with radiation to the right back or shoulder and a positive reaction to analgesics. […] Acute cholecystitis should be suspected in a patient with fever, severe pain located in the right upper abdominal quadrant lasting for several hours, and right upper abdominal pain and tenderness on palpation (the Murphy sign). […] Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease; it is the most sensitive, specific, noninvasive, and inexpensive test for the detection of gallstones.

• #23 Gallstones: Watch and wait, or intervene? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/85/4/323

  Gallstones are common in the United States, affecting an estimated 1 in 7 adults. […] Abdominal ultrasonography is the diagnostic test of choice to detect gallstones and assess for findings suggestive of acute cholecystitis and dilation of the common bile duct. […] Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones, acute cholecystitis, and gallstone pancreatitis. […] Transabdominal ultrasonography, with a sensitivity of 84% to 89% and a specificity of up to 99%, is the test of choice for detecting gallstones. […] The characteristic findings of acute cholecystitis on ultrasonography include enlargement of the gallbladder, thickening of the gallbladder wall, presence of pericholecystic fluid, and tenderness elicited by the ultrasound probe over the gallbladder (sonographic Murphy sign).

• #24 Cholelithiasis – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/cholelithiasis

  Cholelithiasis is the presence of one or more calculi (gallstones) in the gallbladder. […] Diagnosis is usually by ultrasonography. […] Gallstones are suspected in patients with biliary colic. Abdominal ultrasonography is the imaging test of choice for detecting gallbladder stones; sensitivity and specificity are 95%. Ultrasonography also accurately detects sludge. […] Asymptomatic gallstones and biliary sludge are often detected incidentally when imaging, usually ultrasonography, is done for other reasons. […] Patients with asymptomatic gallstones become symptomatic at a rate of about 2% per year. […] Abdominal ultrasonography is 95% sensitive and specific for detecting gallbladder stones.

• #25 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease; it is the most sensitive, specific, noninvasive, and inexpensive test for the detection of gallstones. […] Sensitivity is variable and dependent upon operator proficiency, but in general, it is highly sensitive and specific for gallstones greater than 2 mm. […] Ultrasonography is very useful for diagnosing uncomplicated acute cholecystitis. […] Common bile duct (CBD) stones are missed frequently on transabdominal ultrasonography (sensitivity, 15%-40%). […] Endoscopic ultrasound (EUS) is also an accurate and relatively noninvasive technique to identify stones in the distal common bile duct. […] Computed tomography (CT) scanning is more expensive and less sensitive than ultrasonography for the detection of gallbladder stones.

• #26 Gallstone disease – symptoms, causes and diagnosis at different stages of cholelithiasis

  https://medconsonline.com/en/blog/gallstones

  Gallstones are accumulations of crystals in the gallbladder or bile ducts, which may have different compositions. These can be the cause of gallstone disease (the medical term is cholelithiasis). […] If cholelithiasis is suspected, a comprehensive examination by a general practitioner or gastroenterologist is carried out. An integral part of it is ultrasound examination. Depending on the nature of complaints, other diagnostic procedures are also used. […] Sonography is a standard procedure for diagnosing stones and other issues in the gallbladder. Crystals larger than two millimeters can be detected in 95% of cases. […] CT or MRI can be useful in the case of complications, such as perforation and bile duct stones, or to rule out tumors. However, they are mostly unnecessary in the detection of gallstones and acute cholecystitis.

• #27 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease; it is the most sensitive, specific, noninvasive, and inexpensive test for the detection of gallstones. […] Sensitivity is variable and dependent upon operator proficiency, but in general, it is highly sensitive and specific for gallstones greater than 2 mm. […] Ultrasonography is very useful for diagnosing uncomplicated acute cholecystitis. […] Common bile duct (CBD) stones are missed frequently on transabdominal ultrasonography (sensitivity, 15%-40%). […] Endoscopic ultrasound (EUS) is also an accurate and relatively noninvasive technique to identify stones in the distal common bile duct. […] Computed tomography (CT) scanning is more expensive and less sensitive than ultrasonography for the detection of gallbladder stones.

• #28 Gallstones: Watch and wait, or intervene? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/85/4/323

  Gallstones are common in the United States, affecting an estimated 1 in 7 adults. […] Abdominal ultrasonography is the diagnostic test of choice to detect gallstones and assess for findings suggestive of acute cholecystitis and dilation of the common bile duct. […] Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones, acute cholecystitis, and gallstone pancreatitis. […] Transabdominal ultrasonography, with a sensitivity of 84% to 89% and a specificity of up to 99%, is the test of choice for detecting gallstones. […] The characteristic findings of acute cholecystitis on ultrasonography include enlargement of the gallbladder, thickening of the gallbladder wall, presence of pericholecystic fluid, and tenderness elicited by the ultrasound probe over the gallbladder (sonographic Murphy sign).

• #29 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  The Japanese Society of Gastroenterology guidelines recommend the following stepwise algorithm for the diagnosis of cholelithiasis: Step 1: History and physical examination. Step 2: Blood tests, ultrasonography, and abdominal radiograph. […] A retrospective study that reviewed the records of 186 patients who underwent cholecystectomy reported 3 signs on preoperative US to be predictive of acute cholecystitis: gallbladder distention, wall edema, and pericholecystic fluid collection. […] A retrospective review by Sharif et al of 577 patients found the sensitivity and specificity of point-of-care ultrasound for diagnosing cholelithiasis to be 95.2% and 93.1%, respectively. […] The false-negative rate is 1-4%. […] Hepatobiliary imaging is a functional imaging tool used to diagnose acute cholecystitis and evaluate gallbladder contractility with determination of the gallbladder ejection fraction.

• #30 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease; it is the most sensitive, specific, noninvasive, and inexpensive test for the detection of gallstones. […] Sensitivity is variable and dependent upon operator proficiency, but in general, it is highly sensitive and specific for gallstones greater than 2 mm. […] Ultrasonography is very useful for diagnosing uncomplicated acute cholecystitis. […] Common bile duct (CBD) stones are missed frequently on transabdominal ultrasonography (sensitivity, 15%-40%). […] Endoscopic ultrasound (EUS) is also an accurate and relatively noninvasive technique to identify stones in the distal common bile duct. […] Computed tomography (CT) scanning is more expensive and less sensitive than ultrasonography for the detection of gallbladder stones.

• #31 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease; it is the most sensitive, specific, noninvasive, and inexpensive test for the detection of gallstones. […] Sensitivity is variable and dependent upon operator proficiency, but in general, it is highly sensitive and specific for gallstones greater than 2 mm. […] Ultrasonography is very useful for diagnosing uncomplicated acute cholecystitis. […] Common bile duct (CBD) stones are missed frequently on transabdominal ultrasonography (sensitivity, 15%-40%). […] Endoscopic ultrasound (EUS) is also an accurate and relatively noninvasive technique to identify stones in the distal common bile duct. […] Computed tomography (CT) scanning is more expensive and less sensitive than ultrasonography for the detection of gallbladder stones.

• #32 Gallstones – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gallstones/diagnosis-treatment/drc-20354220

  Tests and procedures used to diagnose gallstones and complications of gallstones include: […] Abdominal ultrasound. This test is the one most commonly used to look for signs of gallstones. […] Endoscopic ultrasound (EUS). This procedure can help identify smaller stones that may be missed on an abdominal ultrasound. […] Other imaging tests. Additional tests may include oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, computerized tomography (CT), magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered using ERCP can be removed during the procedure. […] Blood tests. Blood tests may reveal infection, jaundice, pancreatitis or other complications caused by gallstones. […] Your doctor will determine if treatment for gallstones is indicated based on your symptoms and the results of diagnostic testing.

• #33 Diagnosis and Treatment of Gallstones | Sydney Gut Clinic

  https://sydneygutclinic.com/diagnosis-and-treatment-of-gallstones/

  Gallstones are hardened deposits of digestive fluid that can form in your gallbladder; a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. […] If youre experiencing pain along with vomiting and fever, your doctor may ask you to do a few tests to confirm the diagnosis. There are a few procedures that are used to diagnose gallstones. […] Abdominal ultrasound scan: this is the most common test used to look for signs of gallstones. […] Endoscopic ultrasound: This procedure helps identify smaller stones that may be missed in an abdominal ultrasound. […] Blood tests: Blood tests are generally done to detect any changes in your blood that reveal inflammation of the gall bladder, Liver and/or Pancreas. […] CT (computerized tomography) scan: to spot gallbladder complications such as stones, ruptures and infections.

• #34 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease; it is the most sensitive, specific, noninvasive, and inexpensive test for the detection of gallstones. […] Sensitivity is variable and dependent upon operator proficiency, but in general, it is highly sensitive and specific for gallstones greater than 2 mm. […] Ultrasonography is very useful for diagnosing uncomplicated acute cholecystitis. […] Common bile duct (CBD) stones are missed frequently on transabdominal ultrasonography (sensitivity, 15%-40%). […] Endoscopic ultrasound (EUS) is also an accurate and relatively noninvasive technique to identify stones in the distal common bile duct. […] Computed tomography (CT) scanning is more expensive and less sensitive than ultrasonography for the detection of gallbladder stones.

• #35 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  Although cholescintigraphy is recognized to have a higher sensitivity and specificity, US remains the initial test of choice for imaging patients with suspected acute cholecystitis (AC). […] Only 74-79% of gallstones are identified in patients with computed tomography (CT) scanning. […] Magnetic resonance imaging (MRI) is not a diagnostic screening tool for cholelithiasis. […] The ACR guidelines for evaluation of right upper quadrant pain include the following: Ultrasonography (US) is preferred as the initial imaging study for right upper quadrant pain, with supplemental cholescintigraphy performed when US results are equivocal. […] The European Association for the Study of the Liver (EASL) guidelines recommend that abdominal ultrasonography be used as the primary diagnostic imaging tool for suspected gallstones.

• #36

  https://www.nhs.uk/conditions/gallstones/diagnosis/

  Gallstones may be discovered during tests for a different condition, as they often don’t cause any symptoms. […] If you have symptoms of gallstones, make an appointment with a GP so they can try to identify the problem. […] The GP will ask about your symptoms in detail and may carry out the Murphy’s sign test to help determine if your gallbladder is inflamed. […] Your GP may also recommend having blood tests to look for signs of infection or check if your liver is working normally. […] If your symptoms and test results suggest you may have gallstones, you’ll usually be referred for further tests. […] Gallstones can usually be confirmed using an ultrasound scan, which uses high-frequency sound waves to create an image of the inside of the body. […] When gallstones are diagnosed, there may be some uncertainty about whether any stones have passed into the bile duct. […] An MRI scan may be carried out to look for gallstones in the bile ducts. […] A procedure called a cholangiography can give further information about the condition of your gallbladder. […] A CT scan may be carried out to look for any complications of gallstones, such as acute pancreatitis.

• #37 Gallstones – Diagnosis and Treatment

  https://www.radiologyinfo.org/en/info/gallstones

  Your doctor may use abdominal CT, magnetic resonance cholangiopancreatography (MRCP), or abdominal ultrasound to help diagnose your condition. […] Imaging is used to provide your doctor with valuable information about gallstones, such as location, size and effect on organ function. […] Some types of imaging that your doctor may order include: Abdominal ultrasound: Ultrasound produces pictures of the gallbladder and bile ducts. It shows signs of inflammation or indications that there is blockage of bile flow. […] Abdominal CT: CT rapidly produces detailed pictures of the gallbladder and bile ducts to look for signs of inflammation or indications that there is blockage of bile flow. […] Magnetic resonance cholangiopancreatography (MRCP): MRCP is an MRI exam that produces detailed images of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. It identifies gallstones and can show gallbladder or bile duct inflammation or blockage.

• #38 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  The Japanese Society of Gastroenterology guidelines recommend the following stepwise algorithm for the diagnosis of cholelithiasis: Step 1: History and physical examination. Step 2: Blood tests, ultrasonography, and abdominal radiograph. […] A retrospective study that reviewed the records of 186 patients who underwent cholecystectomy reported 3 signs on preoperative US to be predictive of acute cholecystitis: gallbladder distention, wall edema, and pericholecystic fluid collection. […] A retrospective review by Sharif et al of 577 patients found the sensitivity and specificity of point-of-care ultrasound for diagnosing cholelithiasis to be 95.2% and 93.1%, respectively. […] The false-negative rate is 1-4%. […] Hepatobiliary imaging is a functional imaging tool used to diagnose acute cholecystitis and evaluate gallbladder contractility with determination of the gallbladder ejection fraction.

• #39 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  The Japanese Society of Gastroenterology guidelines recommend the following stepwise algorithm for the diagnosis of cholelithiasis: Step 1: History and physical examination. Step 2: Blood tests, ultrasonography, and abdominal radiograph. […] A retrospective study that reviewed the records of 186 patients who underwent cholecystectomy reported 3 signs on preoperative US to be predictive of acute cholecystitis: gallbladder distention, wall edema, and pericholecystic fluid collection. […] A retrospective review by Sharif et al of 577 patients found the sensitivity and specificity of point-of-care ultrasound for diagnosing cholelithiasis to be 95.2% and 93.1%, respectively. […] The false-negative rate is 1-4%. […] Hepatobiliary imaging is a functional imaging tool used to diagnose acute cholecystitis and evaluate gallbladder contractility with determination of the gallbladder ejection fraction.

• #40 Gallstones: Watch and wait, or intervene? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/85/4/323

  Acute cholecystitis is primarily a clinical diagnosis and typically does not require additional imaging beyond ultrasonography. […] When there is discordance between clinical and ultrasonographic findings, the most accurate second imaging test is scintigraphy of the biliary tract. […] Scintigraphy is more sensitive than abdominal ultrasonography, with a sensitivity of up to 97% vs 81% to 88%, respectively. […] For patients experiencing acute cholecystitis, laparoscopic cholecystectomy within 72 hours is recommended. […] If the patient cannot undergo surgery, percutaneous cholecystotomy or novel endoscopic gallbladder drainage interventions can be used.

• #41 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) has emerged as an excellent imaging study for the noninvasive identification of gallstones anywhere in the biliary tract, including the common bile duct. […] Technetium-99m (99m Tc) hepatoiminodiacetic acid (HIDA) scintigraphy is occasionally useful in the differential diagnosis of acute abdominal pain. […] Endoscopic retrograde cholangiopancreatography (ERCP) permits radiographic imaging of the bile ducts. […] Percutaneous transhepatic cholangiography (PTC) may be the modality of choice in patients in whom ERCP is difficult.

• #42 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) has emerged as an excellent imaging study for the noninvasive identification of gallstones anywhere in the biliary tract, including the common bile duct. […] Technetium-99m (99m Tc) hepatoiminodiacetic acid (HIDA) scintigraphy is occasionally useful in the differential diagnosis of acute abdominal pain. […] Endoscopic retrograde cholangiopancreatography (ERCP) permits radiographic imaging of the bile ducts. […] Percutaneous transhepatic cholangiography (PTC) may be the modality of choice in patients in whom ERCP is difficult.

• #43 Gallstones top to toe: what the radiologist needs to know | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1186/s13244-019-0825-4

  MRI is another very effective tool for diagnosing gallstones and associated pathological processes. […] MRCP has largely replaced endoscopic retrograde cholangiopancreatography (ERCP) as the gold standard for diagnosing choledocholithiasis due to its high sensitivity of 90-94% and specificity of 95-99% without the use of ionising radiation or ERCP-related complications such as pancreatitis which can result in significant morbidity and even mortality. […] Nuclear medicine imaging with scintigraphy and with SPECT/CT can be used to dynamically assess the gallbladder. […] There is an increasing role for interventional radiology (IR) in gallstone-related diseases. […] The broad spectrum of gallstone-related disease can be broken down based on the anatomical locations in which they occur.

• #44 Gallstones – Diagnosis and Treatment

  https://www.radiologyinfo.org/en/info/gallstones

  Your doctor may use abdominal CT, magnetic resonance cholangiopancreatography (MRCP), or abdominal ultrasound to help diagnose your condition. […] Imaging is used to provide your doctor with valuable information about gallstones, such as location, size and effect on organ function. […] Some types of imaging that your doctor may order include: Abdominal ultrasound: Ultrasound produces pictures of the gallbladder and bile ducts. It shows signs of inflammation or indications that there is blockage of bile flow. […] Abdominal CT: CT rapidly produces detailed pictures of the gallbladder and bile ducts to look for signs of inflammation or indications that there is blockage of bile flow. […] Magnetic resonance cholangiopancreatography (MRCP): MRCP is an MRI exam that produces detailed images of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. It identifies gallstones and can show gallbladder or bile duct inflammation or blockage.

• #45 Gallstones (Cholelithiasis) Workup: Approach Considerations, Hematologic Studies, Abdominal Radiography

  https://emedicine.medscape.com/article/175667-workup

  Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) has emerged as an excellent imaging study for the noninvasive identification of gallstones anywhere in the biliary tract, including the common bile duct. […] Technetium-99m (99m Tc) hepatoiminodiacetic acid (HIDA) scintigraphy is occasionally useful in the differential diagnosis of acute abdominal pain. […] Endoscopic retrograde cholangiopancreatography (ERCP) permits radiographic imaging of the bile ducts. […] Percutaneous transhepatic cholangiography (PTC) may be the modality of choice in patients in whom ERCP is difficult.

• #46 Making the Diagnosis of Gallbladder Disease

  https://www.verywellhealth.com/diagnosis-of-gallbladder-disease-4163874

  A computed tomography (CT) scan of your abdomen may also reveal signs of gallbladder disease, like gallbladder wall swelling or fat stranding. […] This non-invasive imaging test allows a healthcare provider to evaluate the bile ducts both inside and outside the liver. […] An ERCP is both a diagnostic and potentially therapeutic test. […] If gallbladder disease is suspected, the healthcare provider may look for the „Murphy sign.” […] Blood tests cannot diagnose gallbladder disease, but they check for abnormalities suggestive of gallstones, biliary dyskinesia, and other forms of gallbladder disease. […] There are several non-invasive imaging tests healthcare providers can use to diagnose gallbladder disease: Abdominal ultrasound, used to detect gallstones, polyps, masses, or abnormal changes to the gallbladder or liver.

• #47 Diagnosis of Gallstones – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/diagnosis

  Doctors use your medical history, a physical exam, and lab and imaging tests to diagnose gallstones. […] Health care professionals may use lab or imaging tests to diagnose gallstones. […] A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show signs of infection or inflammation of the bile ducts, gallbladder, pancreas, or liver. […] Health care professionals use imaging tests to find gallstones. […] Ultrasound is the best imaging test for finding gallstones. […] CT scans can show gallstones, or complications such as infection and blockage of the gallbladder or bile ducts. […] MRIs can show gallstones in the ducts of the biliary tract. […] Doctors use cholescintigraphy to diagnose abnormal contractions of your gallbladder or a blockage in the bile ducts. […] ERCP helps the health care professional locate the affected bile duct and the gallstones.

• #48 Gallstones – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/gallstones/diagnosis-treatment/drc-20354220

  Tests and procedures used to diagnose gallstones and complications of gallstones include: […] Abdominal ultrasound. This test is the one most commonly used to look for signs of gallstones. […] Endoscopic ultrasound (EUS). This procedure can help identify smaller stones that may be missed on an abdominal ultrasound. […] Other imaging tests. Additional tests may include oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, computerized tomography (CT), magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered using ERCP can be removed during the procedure. […] Blood tests. Blood tests may reveal infection, jaundice, pancreatitis or other complications caused by gallstones. […] Your doctor will determine if treatment for gallstones is indicated based on your symptoms and the results of diagnostic testing.

• #49 Gall Bladder Disease: Advances in Diagnosis & Management – Walter Bushnell Healthcare Foundation

  https://wbhf.walterbushnell.com/publications/gastro-flash/item/25-gall-bladder-disease-advances-in-diagnosis-management

  Ultrasound is the test of choice and scintigraphy should be the second option. […] Endoscopic retrograde cholangiopancreatography is considered the gold standard in the detection of common bile duct stones, with a sensitivity and specificity approaching 95%. […] Imaging is considered as the central diagnostic procedure in patients with gallstones. Though many newer diagnostic imaging techniques have been invented, ultrasonography is still considered the best. […] The treatment of gallstones depends upon the stage of disease. Guidelines from the American College of Physicians state that in asymptomatic patients, the risks of both surgical and nonsurgical treatments for gallstones outweigh the benefits.

• #50 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  The Japanese Society of Gastroenterology guidelines recommend the following stepwise algorithm for the diagnosis of cholelithiasis: Step 1: History and physical examination. Step 2: Blood tests, ultrasonography, and abdominal radiograph. […] A retrospective study that reviewed the records of 186 patients who underwent cholecystectomy reported 3 signs on preoperative US to be predictive of acute cholecystitis: gallbladder distention, wall edema, and pericholecystic fluid collection. […] A retrospective review by Sharif et al of 577 patients found the sensitivity and specificity of point-of-care ultrasound for diagnosing cholelithiasis to be 95.2% and 93.1%, respectively. […] The false-negative rate is 1-4%. […] Hepatobiliary imaging is a functional imaging tool used to diagnose acute cholecystitis and evaluate gallbladder contractility with determination of the gallbladder ejection fraction.

• #51 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  Although cholescintigraphy is recognized to have a higher sensitivity and specificity, US remains the initial test of choice for imaging patients with suspected acute cholecystitis (AC). […] Only 74-79% of gallstones are identified in patients with computed tomography (CT) scanning. […] Magnetic resonance imaging (MRI) is not a diagnostic screening tool for cholelithiasis. […] The ACR guidelines for evaluation of right upper quadrant pain include the following: Ultrasonography (US) is preferred as the initial imaging study for right upper quadrant pain, with supplemental cholescintigraphy performed when US results are equivocal. […] The European Association for the Study of the Liver (EASL) guidelines recommend that abdominal ultrasonography be used as the primary diagnostic imaging tool for suspected gallstones.

• #52 Gallstone (Cholelithiasis) Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/366246-overview

  Although cholescintigraphy is recognized to have a higher sensitivity and specificity, US remains the initial test of choice for imaging patients with suspected acute cholecystitis (AC). […] Only 74-79% of gallstones are identified in patients with computed tomography (CT) scanning. […] Magnetic resonance imaging (MRI) is not a diagnostic screening tool for cholelithiasis. […] The ACR guidelines for evaluation of right upper quadrant pain include the following: Ultrasonography (US) is preferred as the initial imaging study for right upper quadrant pain, with supplemental cholescintigraphy performed when US results are equivocal. […] The European Association for the Study of the Liver (EASL) guidelines recommend that abdominal ultrasonography be used as the primary diagnostic imaging tool for suspected gallstones.

• #53 Surgical and Nonsurgical Management of Gallstones | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0515/p795.html

  After an episode, physical examination findings are usually normal, with the possible exception of residual upper abdominal tenderness. […] Acute cholecystitis is an inflammation of the gallbladder caused by gallstones blocking the cystic duct. […] The recommended initial imaging study for most patients with suspected gallstones or a complication of gallstones is abdominal ultrasonography. […] Magnetic resonance cholangiopancreatography is a noninvasive study with high sensitivity and specificity for the detection of gallstones. […] Choledocholithiasis is found in 6% to 12% of patients with gallstones; it increases the risk of recurrent symptoms, pancreatitis, and cholangitis. […] Laboratory studies recommended for patients with suspected complications of gallstones include a complete blood count and measurement of hepatic transaminase, total bilirubin, alkaline phosphatase, amylase, and lipase levels.

• #54 Diagnosis

  https://www2.hse.ie/conditions/gallstones/diagnosis/

  An ultrasound scan can usually confirm if you have gallstones. […] When your GP diagnoses gallstones, it may not be clear if any stones have passed into the bile duct. […] Gallstones in the bile duct are sometimes seen during an ultrasound scan. If they’re not visible but your tests suggest they may be affecting the bile duct then you may need an MRI scan or a cholangiography. […] Your doctor may want to look for gallstones in the bile ducts. To do this you may need a magnetic resonance imaging (MRI) scan. […] A cholangiography can give further information about the condition of your gallbladder. […] If your doctor finds a blockage during this test, they may try to remove it at this point using an endoscope. […] Your doctor will take a CT scan to look for any complications of gallstones. […] CT scans are often done in an emergency to diagnose severe abdominal pain.

• #55 Diagnosis

  https://www2.hse.ie/conditions/gallstones/diagnosis/

  An ultrasound scan can usually confirm if you have gallstones. […] When your GP diagnoses gallstones, it may not be clear if any stones have passed into the bile duct. […] Gallstones in the bile duct are sometimes seen during an ultrasound scan. If they’re not visible but your tests suggest they may be affecting the bile duct then you may need an MRI scan or a cholangiography. […] Your doctor may want to look for gallstones in the bile ducts. To do this you may need a magnetic resonance imaging (MRI) scan. […] A cholangiography can give further information about the condition of your gallbladder. […] If your doctor finds a blockage during this test, they may try to remove it at this point using an endoscope. […] Your doctor will take a CT scan to look for any complications of gallstones. […] CT scans are often done in an emergency to diagnose severe abdominal pain.

• #56 Gallstones top to toe: what the radiologist needs to know | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1186/s13244-019-0825-4

  The typical imaging features of acute cholecystitis are as follows: gallbladder wall thickening, pericholecystic fluid and a distended gallbladder. […] Imaging will demonstrate evidence of gastric outlet or duodenal obstruction related to a gallstone in the upper GI tract. […] It is important that any patient in whom choledocholithiasis is suspected undergo MRCP prior to surgery. […] Late post-cholecystectomy complications can include stump cholecystitis or a retained cystic duct stump or common bile duct stone. […] Radiologists should be familiar with the wide range of pathological processes that can be seen secondary to gallstones in order to aid prompt diagnosis, treatment and intervention.

• #57 Gallstone disease differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Gallstone_disease_differential_diagnosis

  Gallstone disease must be differentiated from other diseases that cause right upper quadrant pain including gastroesophageal reflux disorder, peptic ulcer disease, hepatitis, sphincter of Oddi dysfunction, appendicitis, bile duct stricture, chronic pancreatitis, irritable bowel syndrome, ischemic heart disease, pyelonephritis, ureteral calculi and complications of gallstone disease include: acute cholecystitis, choledocholithiasis, acute pancreatitis, and acute cholangitis. […] The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. […] Patients who present with biliary colic are more likely to have gallstones detected on imaging. […] However, it is important to note that biliary colic can be concomitant in patients with other biliary disorders such as acute cholecystitis, choledocholithiasis, sphincter of Oddi dysfunction, and functional gallbladder disorder.

• #58 Gallstone disease differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Gallstone_disease_differential_diagnosis

  Gallstone disease must be differentiated from other diseases that cause right upper quadrant pain including gastroesophageal reflux disorder, peptic ulcer disease, hepatitis, sphincter of Oddi dysfunction, appendicitis, bile duct stricture, chronic pancreatitis, irritable bowel syndrome, ischemic heart disease, pyelonephritis, ureteral calculi and complications of gallstone disease include: acute cholecystitis, choledocholithiasis, acute pancreatitis, and acute cholangitis. […] The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. […] Patients who present with biliary colic are more likely to have gallstones detected on imaging. […] However, it is important to note that biliary colic can be concomitant in patients with other biliary disorders such as acute cholecystitis, choledocholithiasis, sphincter of Oddi dysfunction, and functional gallbladder disorder.

• #59 Gallstone disease differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Gallstone_disease_differential_diagnosis

  Gallstone disease must be differentiated from other diseases that cause right upper quadrant pain including gastroesophageal reflux disorder, peptic ulcer disease, hepatitis, sphincter of Oddi dysfunction, appendicitis, bile duct stricture, chronic pancreatitis, irritable bowel syndrome, ischemic heart disease, pyelonephritis, ureteral calculi and complications of gallstone disease include: acute cholecystitis, choledocholithiasis, acute pancreatitis, and acute cholangitis. […] The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. […] Patients who present with biliary colic are more likely to have gallstones detected on imaging. […] However, it is important to note that biliary colic can be concomitant in patients with other biliary disorders such as acute cholecystitis, choledocholithiasis, sphincter of Oddi dysfunction, and functional gallbladder disorder.

• #60 Gallstone disease differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Gallstone_disease_differential_diagnosis

  Gallstone disease must be differentiated from other diseases that cause right upper quadrant pain including gastroesophageal reflux disorder, peptic ulcer disease, hepatitis, sphincter of Oddi dysfunction, appendicitis, bile duct stricture, chronic pancreatitis, irritable bowel syndrome, ischemic heart disease, pyelonephritis, ureteral calculi and complications of gallstone disease include: acute cholecystitis, choledocholithiasis, acute pancreatitis, and acute cholangitis. […] The presence of biliary colic is an important diagnostic feature to distinguish between gallstones and non-biliary stone disorders. […] Patients who present with biliary colic are more likely to have gallstones detected on imaging. […] However, it is important to note that biliary colic can be concomitant in patients with other biliary disorders such as acute cholecystitis, choledocholithiasis, sphincter of Oddi dysfunction, and functional gallbladder disorder.

• #61 How To Diagnose Gallstones – One Step Diagnostic

  https://onestepdiagnostic.com/how-to-diagnose-gallstones/

  A CT scan is a more thorough imaging test that utilizes x-rays and computer technology to produce detailed images of the gallbladder and surrounding structures. […] A healthcare professional will conduct a differential diagnosis when a patient exhibits symptoms related to gallstones to identify the underlying cause of the symptoms. […] To identify the underlying cause of a persons symptoms, a healthcare professional will ask about the patients complete medical history, perform a physical examination, and order diagnostic testing. […] It is crucial to visit a healthcare professional if you are exhibiting any gallbladder-related symptoms. […] In conclusion, a combination of medical history, physical examination, blood testing, and imaging tests may be used to diagnose gallstones. […] For a correct diagnosis and treatment plan, its crucial to consult a doctor if youre displaying symptoms like nausea, jaundice, or abdominal pain. […] Always remember that early detection and treatment can improve your general health and well-being and help prevent complications.

• #62 How To Diagnose Gallstones – One Step Diagnostic

  https://onestepdiagnostic.com/how-to-diagnose-gallstones/

  For the diagnosis of gallstones, doctors use a variety of tests. […] If your doctor suspects gallbladder disease, he will ask you about your symptoms and whether anyone in your family has ever experienced gallbladder issues. […] The doctor you see will do a physical examination, focusing on your vital signs first. […] Blood tests can check for signs of infection or inflammation, as well as elevated levels of liver enzymes, which may indicate a problem with the gallbladder or bile ducts. […] Obtaining an abdominal ultrasound (and other imaging tests) is the most crucial step in the diagnostic procedure. […] Sound waves are used in an ultrasound test to capture gallbladder images. […] Gallstones within the gallbladder can be easily seen by ultrasound, as can symptoms such as a thicker gallbladder wall that indicate gallbladder inflammation.

• #63

  https://www.nhs.uk/conditions/gallstones/

  Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. In most cases, they do not cause any symptoms and do not need to be treated. […] When gallstones cause symptoms or complications, it’s known as gallstone disease or cholelithiasis. […] Treatment is usually only necessary if gallstones are causing symptoms, such as tummy pain, or complications, such as jaundice or acute pancreatitis. […] Gallstone disease is usually easily treated with surgery.

• #64 Gallstones: Watch and wait, or intervene? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/85/4/323

  Gallstones are common in the United States, affecting an estimated 1 in 7 adults. […] Abdominal ultrasonography is the diagnostic test of choice to detect gallstones and assess for findings suggestive of acute cholecystitis and dilation of the common bile duct. […] Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones, acute cholecystitis, and gallstone pancreatitis. […] Transabdominal ultrasonography, with a sensitivity of 84% to 89% and a specificity of up to 99%, is the test of choice for detecting gallstones. […] The characteristic findings of acute cholecystitis on ultrasonography include enlargement of the gallbladder, thickening of the gallbladder wall, presence of pericholecystic fluid, and tenderness elicited by the ultrasound probe over the gallbladder (sonographic Murphy sign).

• #65 Management of Gallstones and Their Complications | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0315/p1673.html

  Endoscopic retrograde cholangiopancreatography (ERCP) is the best method for determining a diagnosis of choledocholithiasis. […] The latest computer technology, processing computed tomographic (CT) and magnetic resonance imaging (MRI) data into a three-dimensional image of the bile duct, is now comparable to the ERCP in terms of diagnostic accuracy. […] Hepatobiliary scintigraphy can confirm or exclude the diagnosis of acute cholecystitis with a high degree of sensitivity and specificity. […] Cholelithiasis can be diagnosed in a variety of clinical circumstances. […] It is estimated that 60 to 80 percent of all gallstones are asymptomatic at some point. […] Once an episode of biliary colic has occurred, there is a high risk of repeated pain attacks. […] Most physicians agree that early laparoscopic cholecystectomy (within 24 to 48 hours) is indicated once the diagnosis of acute cholecystitis is secure and the patient is hemodynamically stable. […] When a patient with known gallbladder stones has concomitant choledocholithiasis, the management varies with the severity of clinical features.

• #66 Gallstones: Watch and wait, or intervene? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/85/4/323

  Acute cholecystitis is primarily a clinical diagnosis and typically does not require additional imaging beyond ultrasonography. […] When there is discordance between clinical and ultrasonographic findings, the most accurate second imaging test is scintigraphy of the biliary tract. […] Scintigraphy is more sensitive than abdominal ultrasonography, with a sensitivity of up to 97% vs 81% to 88%, respectively. […] For patients experiencing acute cholecystitis, laparoscopic cholecystectomy within 72 hours is recommended. […] If the patient cannot undergo surgery, percutaneous cholecystotomy or novel endoscopic gallbladder drainage interventions can be used.

• #67 Gallstones: Watch and wait, or intervene? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/85/4/323

  Acute cholecystitis is primarily a clinical diagnosis and typically does not require additional imaging beyond ultrasonography. […] When there is discordance between clinical and ultrasonographic findings, the most accurate second imaging test is scintigraphy of the biliary tract. […] Scintigraphy is more sensitive than abdominal ultrasonography, with a sensitivity of up to 97% vs 81% to 88%, respectively. […] For patients experiencing acute cholecystitis, laparoscopic cholecystectomy within 72 hours is recommended. […] If the patient cannot undergo surgery, percutaneous cholecystotomy or novel endoscopic gallbladder drainage interventions can be used.

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