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April 3, 1978

Ultrasound in the Investigation of Gallbladder Disease

Author Affiliations

From the Department of Radiology and Radiological Sciences, The Johns Hopkins Medical Institutions, Baltimore. Dr Kappelman is now with Hollywood Memorial Hospital, Hollywood, Fla.

JAMA. 1978;239(14):1426-1428. doi:10.1001/jama.1978.03280410068029

CONVENTIONAL oral cholecystography with iopanoic acid has reached a high degree of diagnostic accuracy and is currently the standard mode of evaluation of gallbladder disease.1 However, it is of limited applicability in several situations:

  1. The acutely ill patient. The study, when using iopanoic acid may take 14 to 48 hours to complete.

  2. The patient who cannot ingest pills. Patients who, because of symptoms or therapy, cannot ingest or retain iopanoic acid or who are undergoing gastric suction must be examined by alternate means.

  3. The patient with jaundice and liver function abnormalities. Although nonvisualization of the gallbladder in most cases is highly specific for gallbladder disease,1 the presence of jaundice or abnormal results from liver function studies is a spurious or nonbiliary cause for nonvisualization and does not necessarily indicate a pathological gallbladder condition.

  4. The patient with a nonbiliary cause for nonvisualization. Nonbiliary causes that may