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Shamil J. Morayati, MD
Newark, Del

JAMA. 1990;263(15):2050-2051.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I read with interest the recent article on the clinical evaluation of jaundice by Dr Frank and members of the Patient Care Committee of the American Gastroenterological Association.¹ The authors reviewed accurately the usefulness of noninvasive studies, including ultrasonography and computed tomographic scan, in the assessment of jaundice. However, the value of cholescintigraphy as an adjunct noninvasive study and in selected cases as the modality of choice in screening patients was overlooked.

Ultrasound is poor at detecting common bile duct stones; not all obstructed ducts are dilated and not all dilated ducts are functionally obstructed, especially after cholecystectomy,^2,3 and therefore cholescintigraphy can play a major role in the diagnosis of obstructed jaundice. Its overall accuracy is reported to be about 96% to 97%.⁴ Cholescintigraphy has a distinct advantage in patients in whom choledocholithiasis is considered to be the most likely cause (eg, acute . . . [Full Text PDF of this Article]

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