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June 1960

Opacifying Gallstones: Utility of a New Examination for the Demonstration of Duct Stones Useful in the Presence of Jaundice

Author Affiliations

From the Divisions of Surgery (Dr. Watkins) and Radiology (Dr. Salzman) of the Denver General Hospital.

AMA Arch Surg. 1960;80(6):986-991. doi:10.1001/archsurg.1960.01290230104013

Our observation of opacification of biliary calculi was made in exploring the possible advantages of prolonged administration of iopanoic acid (Telepaque)* in patients whose gallbladders did not visualize or visualized only faintly after the conventional cholecystogram. We observed that certain radiolucent biliary calculi become radiographically opaque. This procedure has been called "biliary calculography," and the stones having this quality, "opacifying gallstones." Theander1 in 1955 observed a gallstone opacification reaction in a case of cholelithiasis, which, however, was not proved surgically. We have reported surgically proved cases of opacifying gallstones2,3 with experimental reproduction of the phenomenon.3,4

The condition of prolonged exposure of the biliary calculi to cholecystographic contrast medium is fulfilled with the "four-day Telepaque test." The patient is placed on a four-day regimen of 3 gm. of iopanoic acid per day, after each meal. A low-fat diet is observed during the interval. The x-ray examination is made

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