Diagnosis of acute cholecystitis usually can be established firmly on the basis of an accurate history and physical examination and routine laboratory studies. Occasionally, however, typical findings may lead to errors in diagnosis. In other cases the exact cause of upper abdominal pain may remain in doubt after completion of the routine diagnostic evaluation.
Intravenous cholangiography has become a well-established diagnostic procedure for the detection of biliary tract disease.1-5 In an attempt to confirm the usefulness and determine the accuracy of this procedure as an aid in the evaluation of acute abdominal pain, case records were reviewed of 211 consecutive patients in whom intravenous cholangiography was employed in the emergency room of the city-county charity hospitals of Houston and Harris County, Texas. Final diagnoses were established either by operative removal of the diseased tissue and pathological examination, or, as was the case with illnesses not requiring surgical intervention, adequate