Tuesday, March 18, 2014

LIVER BILLIARY TRACT 13 Investigations



13. DIAGNOSTIC TESTS for GB Disorders

13.1 ROUTINE ABDOMINAL X-RAYS

Plain films are indicated in biliary tract disease, since biliary
calculi in upto 20% of cases are calcified. Gallstones visibility
is denpendent upon the amount of calcium present in the stone. 

Ultrasonography  has  been adopted as  the  principle  diagnostic
test.

13.2 ORAL CHOLECYSTOGRAPHY

After  ingestion of telepaque 12 hours earlier, visualization  of
the normal gallbladder takes place.

*  Subsequent  to  the  ingestion of a  fatty  meal,  contraction
   begins  promptly  and within 40 minutes,  the  gallbladder  is
   reduced  to  at least one-third of one-fourth  of  its  normal
   size.

*  An abnormal cholecystogram may demonstrate poor  visualization
   of  the  gallbaldder  or presence of filling  defects  due  to
   presence of calculi or tumours.

*  Non-visualization may be due to :

   *  Failure to retain the oral medication
   *  Faulty absorption such as with pyloric obstruction
   *  Hepatic dysfunction
   *  Hepatic or cystic duct obstruction

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