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January 31, 1977

Ultrasound Examination of the Gallbladder

JAMA. 1977;237(5):448. doi:10.1001/jama.1977.03270320026006

To the Editor.—  The article by Bartrum et al (236:1147, 1976) entitled "Ultrasound Examination of the Gallbladder" brought both good news and bad news. The good news is that ultrasound is a useful method of studying gallbladders that cannot be visualized through the use of contrast material, such as in jaundiced patients.The bad news, however, is the confusion in the authors' minds about the meaning of nonvisualization of the gallbladder following two doses of oral contrast material in which no extrinsic factors (ie, jaundice, vomiting, diarrhea) are present. The authors state that patients who met their third criteria (ie, had gallbladders which were not visualized after two doses of oral contrast material but were visualized on intravenous cholangiograms and did not show stones) were called normal. Mujahed et al1 have clearly documented that this is false; in their series, there were 14 patients with gallbladders that appeared normal