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January 31, 1977

Ultrasound Examination of the Gallbladder-Reply

JAMA. 1977;237(5):448. doi:10.1001/jama.1977.03270320026007

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


Dr Janower's comments are both good news and bad news to us. The bad news is that we were indeed sloppy in our definitions of "normal" and "abnormal" gallbladders. By "normal gallbladder," we meant a gallbladder which did not contain gallstones. We are aware of the work by Mujahed et al; in their article, the definition of "not normal" included cases of "chronic cholecystitis." The value of these authors' conclusion that failure to visualize the gallbladder on two oral examinations indicates gallbladder disease is somewhat diminished by the fact that they had no surgical confirmation in more than half of their cases (193 out of 345). There is also some disagreement as to the clinical significance of "chronic cholecystitis."

The good news is that ultrasound is now available as a useful tool for diagnosing gallstones. How this procedure is integrated with the oral cholecystogram is up to the