THE LONG-APPRECIATED problem of poor gallbladder visualization following a single dose of an orally administered contrast agent continues to stimulate controversy. None of the various orally administered agents consistently gives satisfactory opacification with standard dosage. Nearly everyone agrees that the traditional remedy of a "double dose" (actually a repeat single dose) is costly in both physician and patient time, as well as in increased radiation exposure. Some physicians advocate using a "double dose" initially.1,2 Others believe that this is wasteful, because it subjects the majority of patients to unnecessary overdosage, and prefer diet modifications, oral cholecystogogues, or bile salts.3
We believe that ultrasonic examination of the initially nonvisualized gallbladder is superior to any of these suggestions.
Materials and Methods
Fifty patients with a nonvisualized gallbladder following a single 3-gm dose of tyropanoate sodium (Bilopaque) were examined with a commercially available bistable B-scanner and a 2.25-MHz transducer. The ultrasound
Bartrum RJ, Crow HC, Foote SR. Ultrasound Examination of the Gallbladder: An Alternative to "Double-Dose" Oral Cholecystography. JAMA. 1976;236(10):1147–1148. doi:10.1001/jama.1976.03270110045029
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