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How is a gall bladder disorder diagnosed? – Part 2

– The gallbladder is a sac located under the liver.
– It stores and concentrates bile produced in the liver.
– Bile aids in the digestion of fats.
– Then it is released from the gallbladder into the upper small intestine (duodenum) in response to food, especially fats.

– The challenge in diagnosing gallstones is to verify that abdominal pain is caused by stones and not by some other condition.
– Ultrasound or other imaging techniques can usually detect gallstones.
– Since gallstones are common and most cause no symptoms, simply finding stones does not necessarily explain the pain
– This pain may be caused by any number of ailments.

Imaging and Diagnostic Techniques

1. Ultrasound of the Abdomen
– It is the diagnostic method most frequently used to detect gallstones.
– It is the method of choice for detecting acute cholecystitis.
– If possible, the patient should not eat for 6 or more hours before the test.
– The test takes only about 15 minutes.
– During the procedure, the doctor can check the liver, bile ducts, and pancreas, and quickly scan the gallbladder wall for thickening (characteristic of cholecystitis).

2. Ultrasound can help in the diagnosis varies based on the patient’s situation:
– Ultrasound accurately detects gallstones as small as 2 mm in diameter.
– Some experts recommend that the test be repeated if an ultrasound does not detect stones.
– The health care provider still strongly suspects gallstones.
– Air in the gallbladder wall may indicate gangrene.
– Ultrasound is not very useful for identifying cholecystitis in patients who have symptoms but do not have gallstones.
– Ultrasound is also not as accurate for identifying common bile duct stones or imaging the cystic duct.
– Normal ultrasound results, along with normal bilirubin and liver enzyme tests are very accurate indications that there are no stones in the common bile duct.

3. Endoscopic Ultrasound:
– The physician places an endoscope into the patient’s mouth and down the esophagus, stomach, and then the first part of the small intestine.
– The tip of the endoscope contains a small ultrasound transducer, which provides “close-up” ultrasound images of the anatomy in the area.
– EUS is useful when the health care provider suspects common bile duct stones.
– They are not seen on a regular ultrasound and the patient is not clearly ill.
– If common duct stones are detected, they cannot be removed using this method.

4. X-Rays:
– Standard x-rays of the abdomen may detect calcified gallstones and gas.
– Variations include oral cholecystography or cholangiography.

5. Oral cholecystography:
– The patient takes a tablet containing a dye the night before the test.
– The dye fills the gallbladder.
– X-ray images are taken the next day.
– The test has largely been replaced by ultrasound.
– It may be useful in some cases for determining the structural and functional status of the gallbladder.

6. In cholangiography:
– A dye is injected into the bile duct.
– X-rays are used to view the duct.
– It is typically used during operations to provide a clear image of the biliary tract.

7. Cholescintigraphy (Also Called Gallbladder Radionuclide Scan or HIDA scan):
– Cholescintigraphy is a nuclear imaging technique.
– It is more sensitive than ultrasound for diagnosing acute cholecystitis.
– It is noninvasive but can take 1 – 2 hours or longer.
The procedure involves the following steps:
– A tiny amount of a radioactive dye is injected intravenously.
– This material is excreted into bile.
– The patient lies on a table under a scanning camera, which detects gamma (radioactive) rays emitted by the dye as it passes from the liver into the gallbladder.
– The test can take up to 2 hours, because each image takes about a minute, and images are taken every 5 -15 minutes.

8. Endoscopic Retrograde Cholangiopancreatography (ERCP):
– Endoscopic retrograde cholangiopancreatography (ERCP) has been the gold standard for detecting common bile duct stones.
– This is because stones can be removed during the procedure.
– However, this technique is invasive and carries a risk for complications, including pancreatitis.
– ERCP is now generally limited to patients who have a high likelihood of common bile ducts stones.

9. Computed Tomography:
– Computed tomography (CT) scans may be a valuable additional imaging technique if the doctor suspects complications, such as perforation, common duct stones, or other problems such as cancer in the pancreas or gallbladder.
– Helical (spiral) CT scanning is an advanced technique that is faster and obtains clearer images.

10. Magnetic Resonance Cholangiography (MRCI) or Magnetic Resonance Cholangiopancreatography (MRCP):
– These imaging techniques may be very useful for detecting common bile duct stones and other abnormalities of the biliary tract.
– A dye is injected into the patient’s veins that helps visualize the biliary tract.
– MRCP is extremely sensitive in detecting biliary tract cancer.
– This imaging procedure may not detect very small stones or chronic infections in the pancreas or bile duct.
– It is most likely to be useful who have unclear symptoms that suggest gallbladder or biliary tract problems.

The Liver and Gallbladder Miracle Cleanse Healthy Digestion the Natural Way 3B Scientific VE315 Liver with Gall Bladder, Pancreas and Duodenum Model

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