This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Diagnosis of Cholelithiasis in Patients With Normal Gallbladder X-ray and Ultrasound Studies

Rama P. Venu, MD; Joseph E. Geenen, MD; James Toouli, MD; Edward Stewart, MD; Walter J. Hogan, MD

JAMA. 1983;249(6):758-761.

Abstract
The combination of a normal oral cholecystogram and ultrasound study of the gallbladder is considered adequate evidence to exclude cholelithiasis as a cause of biliarylike pain. We examined 206 patients with biliarylike pain and normal findings on cholecystogram and ultrasound study of the gallbladder by endoscopic retrograde cholangiopancreatography (ERCP). Of the 195 patients who had successful ERCP, 32 patients (group 1) had mild, transient abnormalities in liver function tests and 163 (group 2) had normal liver function test results. Small gallstones were demonstrated on ERCP examination in 25 of 32 group 1 patients and in four of 163 group 2 patients, all confirmed at surgery or endoscopic sphincterotomy. In conclusion, despite negative results on cholecystogram and ultrasound study of the gallbladder, patients with biliarylike pain and abnormal liver function test results should be evaluated further by diagnostic ERCP examination.

(JAMA 1983;249:758-761)

Author Affiliations
From the Departments of Medicine (Drs Venu, Geenen, Toouli, and Hogan) and Radiology (Dr Stewart), Medical College of Wisconsin, Milwaukee.

Footnotes
Presented at the Annual Meeting of the American Society for Gastrointestinal Endoscopy, New York, May 20, 1981.

Reprint requests to the Department of Medicine, Medical College of Wisconsin, 1333 College Ave, Racine, WI 53403 (Dr Geenen).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The possum sphincter of Oddi pumps or resists flow depending on common bile duct pressure: a multilumen manometry study
Grivell et al.
J. Physiol. 2004;558:611-622.
ABSTRACT | FULL TEXT  

How to Image the Gallbladder in Suspected Cholecystitis
Marton and Doubilet
ANN INTERN MED 1988;109:722-729.
ABSTRACT  

Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Unexplained Pancreatitis
Feller
Arch Intern Med 1984;144:1797-1799.
ABSTRACT  

Management of Cholelithiasis
McKenzie
JAMA 1984;251:218-218.
ABSTRACT