liver and gallbladder disorders
Gallstones
Diagnosis of Gallstones
Ultrasonography or other imaging test Doctors suspect gallstones in people with the characteristic pain in the upper abdomen (caused by a swollen gallbladder). Sometimes gallstones are detected when an imaging test such as ultrasonography is done for other reasons. Ultrasonography is the test of choice. It is 95% accurate in detecting gallstones in the gallbladder. It is less accurate in detecting stones in the bile ducts, but it may show that the blockage has caused the ducts to dilate. Other diagnostic tests may be necessary. They include Magnetic Resonance Imaging and Magnetic Resonance Imaging (MRCP) or, if MRCP is unclear, endoscopic ultrasonography (EUS) and/or endoscopic retrograde cholangiopancreatography (ERCP), to check for stones in the bile ducts In endoscopic ultrasonography (EUS), an endoscope that contains a tiny ultrasound device at its tip is passed through the mouth into the stomach and the small intestine. It is positioned near the gallbladder and bile ducts and can show images of the structures there better than standard ultrasonography. For ERCP, a flexible viewing tube (endoscope) with surgical attachments is passed through the mouth, down the esophagus, through the stomach, and into the small intestine (see figure). A thin catheter is passed through the endoscope, into the opening between the small intestine and the common bile and pancreatic ducts and up into the common bile duct. A radiopaque contrast agent, which is visible on x-rays, is then injected through the catheter into the bile ducts, and x-rays are taken to detect any abnormalities. Blood tests to evaluate how well the liver is functioning and whether it is damaged ( Liver Blood Tests ) are done. Results are usually normal unless stones block the bile ducts. When stones block the bile ducts, results are usually abnormal, suggesting a backup of bile in the liver ( 