Diagnosis of gallbladder disease

Gallstones may be diagnosed coincidentally by x-rays taken for other purposes. When symptoms present which suggest gallbladder disease, investigations such as ultrasound scanning of the right upper abdomen can identify stones not clearly visible on plain x-ray. Contrast x-rays done by ERCP (Endoscopic retrograde cholangiopancreatography) are used to outline the gallbladder cavity and the system of biliary ducts (the ‘biliary tree’). This can show the contents of the gallbladder and may also show up a stone obstructing one of the bile ducts. This test is done by passing a long, flexible, telescope with a light at the end via the stomach into the duodenum. This is then passed into the bile duct, where the stones may be visualised, and radio-opaque dye can be injected into the system to outline the gallbladder and bile ducts and reveal any solid contents on x-ray.

In some cases blood tests can identify the effects of inflammation or abnormal levels of bilirubin if there is obstruction of the bile duct.

Diagnosis of cholecystitis is based on the typical history, the nature of associated symptoms, the nature and location of the pain and the results of tests such as abdominal x-ray, ultrasound scans and blood tests that may show signs of infection or abnormalities of liver function.