You will be asked about your symptoms and medical history. A physical exam will be done.
Tests may include:
Blood tests —These tests may be used to find an infection, jaundice, pancreatitis , or an obstruction. For example, if bile flow is blocked, the bile will back up into the liver, which can be detected. Common tests include liver function tests, lipase, amylase, and complete blood count.
Abdominal ultrasound—A device will be held over the abdomen. It will bounce sound waves off the organs and the stones. The sound waves make electrical impulses that create a picture of the organ on a video monitor.
Magnetic resonance cholangiopancreatography (MRCP)—This is an imaging technique using MRI to let the doctor see the biliary and pancreatic ducts. Its purpose is to determine if there is a gallstone blocking any of these ducts. The test allows doctors to visualize the gall bladder, pancreas, and biliary ducts without the use of contrast dye, invasive procedures, or radiation exposure.
Hepatobiliary scintigraphy (HIDA) scan—This is an imaging test to check the function of the gallbladder. You will receive a tracer drug, which is taken up by the gallbladder. This test will help your doctor determine if the organ is functioning properly and if you may have acute cholecystitis.
Abdominal CT scan—This is an imaging test used to visualize the gall bladder, pancreas, and biliary ducts, but with contrast dye and radiation exposure.
Cholecystogram—You will be asked to swallow some tablets containing contrast material. The contrast material is then absorbed into bile, which fills the gallbladder. X-rays are then taken. The x-rays can show movement of the gallbladder, presence of gallstones, and any blockage of the bile ducts.
Endoscopic retrograde cholangiopancreatography (ERCP)—An endoscope is a long, flexible, lighted tube connected to a computer and monitor. The tube is guided through the stomach and into the small intestine. Dye is injected that stains the ducts in the biliary system. When the stones are located, they can also be removed. This method is effective for stones that have entered the common bile duct.
Endoscopic ultrasound—A long, flexible, lighted tube is inserted via the mouth or the rectum to visualize the different parts of digestive tract. A small ultrasound transducer is installed at the tip of the endoscope, which allows the doctor to get the device much closer to the internal organs of the body. This helps to obtain pictures of better quality and accuracy than those obtained through traditional ultrasound.
Gallstones. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/gallstones. Updated November 19, 2014. Accessed September 1, 2017.
Gallstones. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114033/Gallstones. Updated July 22, 2016. Accessed September 1, 2017.
Gallstones. National Institute of Diabetes and Digesrive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones. Updated November 2013. Accessed September 1, 2017.
McVeigh G, Dobinson Evans E, Dwerryhouse S, et al; National Institute for Health and Care Excelleicne (NICE). Gallstone disease. NICE 2014 Oct:CG188. Available at: https://www.nice.org.uk/guidance/cg188/resources/gallstone-disease-diagnosis-and-initial-management-35109819418309.
Portincasa P, et al. Management of gallstones and its related complications. Expert Rev Gastroenterol Hepatol. 2016;10(1):93-112.
6/18/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114033/Gallstones: Yarmish GM, Smith MP, et al. American College of Radiology (ACR) Appropriateness Criteria on right upper quadrant pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/RightUpperQuadrantPain.pdf.
Last reviewed September 2017 by Michael Woods, MD FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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