Diagnosis of Cholelithiasis

Diagnosis of gallstones is quite simple and involves the following methods:

• Ultrasound – this method is the golden standard for diagnosing gallstones. It allows determining the shape, size and number of stones, as well as the state of the biliary and pancreatic ducts. This method can also reveal inflammation, since when the gallbladder is inflamed its walls thicken.
• Radionuclide biliary scan – involves using a radioactive tracer (usually 99Tc-iminodiacetic acid chelate complex) to visualize the gallbladder and biliary system. It can reveal cystic duct obstruction and cholecystitis. This technique is usually used after the ultrasound, if the ultrasound didn’t reveal any abnormalities, but the patient still exhibits symptoms which indicate problems with biliary system. This technique has 97% sensitivity for diagnosing cholecystitis and cholelithiasis.

• X-rays are very rarely used for this purpose since only stones with high content of calcium can be visualized on X-ray scans. Therefore, gallstones are usually found by accident when the X-ray is used to identify some other problem in the abdominal region.