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November 4, 1974

Oral Cholecystography

Author Affiliations

A. B. Chandler Medical Center Lexington, Ky

JAMA. 1974;230(5):672. doi:10.1001/jama.1974.03240050020015

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To the Editor.—  Joseph F. Linsman, MD (229:1419, 1974) voiced disagreement with some statements in my article, "An Evaluation of Oral Cholecystography" (229:76, 1974). His major objection was to a statement in my article in which I indicated that a plain x-ray film of the abdomen may provide information that makes a cholecystogram unnecessary. I went on to indicate that the detection of a radiopaque gallstone was an example of such information. He contends that a radiopaque density in the right upper quadrant on a plain x-ray film of the abdomen is not sufficient to justify its identification as a gallstone without confirmation by cholecystography. I did not indicate that I considered every density in the right upper quadrant to be a gallstone. I presumed that appropriate clinical judgment would be employed. Obviously, if a radiopaque density overlies the kidney shadow, it is necessary to obtain an oblique radiograph to