Diagnosis of Gallstones
Diagnostic Test list for Gallstones:
The list of medical tests
mentioned in various sources as
used in the diagnosis of Gallstones
includes:
Gallstones Diagnosis: Book Excerpts
Tests and diagnosis discussion for Gallstones:
Many gallstones, especially silent stones, are
discovered by accident during tests for other problems. But when
gallstones are suspected to be the cause of symptoms, the doctor is likely
to do an ultrasound exam. Ultrasound uses sound waves to create images of
organs. Sound waves are sent toward the gallbladder through a handheld
device that a technician glides over the abdomen. The sound waves bounce
off the gallbladder, liver, and other organs, and their echoes make
electrical impulses that create a picture of the organ on a video monitor.
If stones are present, the sound waves will bounce off them, too, showing
their location.
Other tests used in diagnosis include
- Cholecystogram or cholescintigraphy. The patient is injected
with a special iodine dye, and x-rays are taken of the gallbladder over
a period of time. (Some people swallow iodine pills the night before the
x-ray.) The test shows the movement of the gallbladder and any
obstruction of the cystic duct.
- Endoscopic retrograde cholangiopancreatography (ERCP). The
patient swallows an endoscope—a long, flexible, lighted tube connected
to a computer and TV monitor. The doctor guides the endoscope through
the stomach and into the small intestine. The doctor then injects a
special dye that temporarily stains the ducts in the biliary system.
ERCP is used to locate stones in the ducts.
- Blood tests. Blood tests may be used to look for signs of
infection, obstruction, pancreatitis, or jaundice.
Gallstone symptoms are similar to those of heart attack, appendicitis,
ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, and
hepatitis. So accurate diagnosis is important.
(Source: excerpt from Gallstones: NIDDK)
Diagnosis of Gallstones: medical news summaries:
The following medical news items
are relevant to diagnosis and misdiagnosis issues for Gallstones:
Diagnostic Tests for Gallstones: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Gallstones.
DROP ATTACKS:
Ask the following questions:
(Algorithmic Diagnosis of Symptoms and Signs)
- Is there loss of consciousness? If there is loss of consciousness, the differential diagnosis for syncope should be considered.
- Are there other neurologic signs and symptoms? Focal neurologic signs and symptoms should make one think of basilar artery insufficiency, cerebral arteriosclerosis, Ménière's disease, and cerebellar atrophy. A brain tumor should also be considered if there are focal signs.
- Is there hypotension, cardiomegaly, or a heart murmur? These findings should make one think of orthostatic hypotension, aortic stenosis and insufficiency, and cardiac arrhythmia.
DIAGNOSTIC WORKUP
Basic studies for the workup of drop attacks are CBC, sedimentation rate, chemistry panel, VDRL test, chest x-ray, and EKG. These will help identify anemia, hypoglycemia, and cardiovascular diseases. An EEG should also be done to rule out epilepsy. If there are focal neurologic signs, a CT scan or MRI should be done. Remember, the MRI is double the cost and the diagnostic yield is only slightly higher. A neurologist should be consulted to help decide which study is appropriate. A 5-hr glucose tolerance test can be done to help diagnose hypoglycemia. Four-vessel angiography is necessary to diagnose vertebral basilar disease. Holter monitoring will be useful to diagnose complete heart block and other cardiac arrhythmias. If the chest x-ray or EKG has revealed possible cardiac findings, a referral to a cardiologist would be wise.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
DROP ATTACKS:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
Basic workup includes a CBC, chemistry panel, urinalysis, carotid doppler study, and ECG. The clinical picture and neurologic or cardiology consult will help determine if Holter monitoring or four-vessel cerebral angiography should be done.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
Calcium imbalance:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Confirming diagnosis A serum calcium level less than 8.5 mg/dl confirms hypocalcemia; a level more than 10.5 mg/dl confirms hypercalcemia. (However, because approximately one-half of serum calcium is bound to albumin, changes in serum protein must be considered when interpreting serum calcium levels. A common conversion formula is calcium corrected = calcium actual + 0.8 x [4.0 – albumin level]. Ionized calcium levels are 4.65 to 5.28 mg/dl and are a measure of the fraction of serum calcium in ionized form.)
The Sulkowitch urine test shows increased calcium precipitation in hypercalcemia. In hypocalcemia, an electrocardiogram (ECG) reveals lengthened QT interval, prolonged ST segment, and arrhythmias; in hypercalcemia, shortened QT interval and heart block. (See Diagnosing hypercalcemia, pages 916 and 917.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cholelithiasis and related disorders:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Echography and X-rays detect gallstones. Other tests may include the following:
❑ Abdominal computed tomography scan or ultrasound reflects stones in the gallbladder.
❑ Percutaneous transhepatic cholangiography, done under fluoroscopic control, distinguishes between gallbladder or bile duct disease and cancer of the pancreatic head in patients with jaundice.
❑ Endoscopic retrograde cholangiopancreatography visualizes the biliary tree after insertion of an endoscope down the esophagus into the duodenum, cannulation of the common bile and pancreatic ducts, and injection of contrast medium.
❑ HIDA scan of the gallbladder detects obstruction of the cystic duct.
❑ Oral cholecystography shows stones in the gallbladder and biliary duct obstruction.
An elevated icteric index and total bilirubin, urine bilirubin, and alkaline phosphatase levels support the diagnosis. The white blood cell count is slightly elevated during a cholecystitis attack. Differential diagnosis is essential because gallbladder disease can mimic other diseases (myocardial infarction, angina, pancreatitis, pancreatic head cancer, pneumonia, peptic ulcer, hiatal hernia, esophagitis, and gastritis). Serum amylase levels distinguish gallbladder disease from pancreatitis. With suspected heart disease, serial cardiac enzyme tests and electrocardiography should precede gallbladder and upper GI diagnostic tests.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Calcium imbalance:
Diagnosis
(Handbook of Diseases)
A serum calcium level below 4.5 mEq/L confirms hypocalcemia; a level above 5.5 mEq/L confirms hypercalcemia. (However, because about half of serum calcium is bound to albumin, changes in serum protein must be considered when interpreting serum calcium levels.)
In patients with hypercalcemia, urine test results show an increase in urine calcium precipitation. In those with hypocalcemia, an electrocardiogram (ECG) reveals a lengthened QT interval, a prolonged ST segment, and arrhythmias; in those with hypercalcemia, an ECG reveals a shortened QT interval and heart block.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Cholelithiasis, cholecystitis, and related disorders:
Diagnosis
(Handbook of Diseases)
Ultrasonography and X-rays detect gallstones. Specific procedures include the following:
❑ Ultrasonography reflects stones in the gallbladder with 96% accuracy.
❑ Percutaneous transhepatic cholangiography allows imaging under fluoroscopic control to help distinguish between gallbladder or bile duct disease and cancer of the pancreatic head in patients with jaundice.
❑ Endoscopic retrograde cholangiopancreatography visualizes the biliary tree after insertion of an endoscope down the esophagus into the duodenum, cannulation of the common bile and pancreatic ducts, and injection of contrast medium.
❑ Hepatobiliary iminodiacetic acid analogue scan of the gallbladder helps detect obstruction of the cystic duct.
❑ Computed tomography scan, although not routinely used, helps distinguish between obstructive and nonobstructive jaundice.
❑ Plain abdominal X-rays identify calcified but not cholesterol stones with 15% accuracy.
❑ Oral cholecystography shows stones in the gallbladder and biliary duct obstruction.
Elevated icteric index and elevated total bilirubin, urine bilirubin, and alkaline phosphatase levels support the diagnosis. White blood cell count is slightly elevated during a cholecystitis attack.
Differential diagnosis is essential because gallbladder disease can mimic other diseases (myocardial infarction, angina, pancreatitis, pancreatic head cancer, pneumonia, peptic ulcer, hiatal hernia, esophagitis, and gastritis). Serum amylase levels help distinguish gallbladder disease from pancreatitis. With suspected heart disease, cardiac enzyme testsand an electrocardiogram should precede gallbladder and upper GI diagnostic tests.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
DROP ATTACKS:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
Basic workup includes a CBC, chemistry panel, urinalysis, carotid
doppler study, and electrocardiogram (ECG). The clinical picture and
neurologic or cardiology consult will help determine if Holter monitoring or
four-vessel cerebral angiography should be done.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
If you've ever experienced an asthma attack, you know how frustrating and unpleasant it can be. And since anything from strong perfume to extreme...
There are two basic types of medications used to treat migraines: drugs to prevent migraines from occurring and drugs to treat the headache once it...
Sexual contact can sometimes result in problems. An unwanted pregnancy or sexually transmitted diseases may be some of those consequences. But by...
Health insurance is important to everyone, especially people with chronic conditions like Crohn's disease and ulcerative colitis. Tune in to...
See full list of 4 related videos
» Next page: Signs of Gallstones
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
