What Is a Cholecystogram?

Oral cholecystography is a common test for diagnosing gallbladder disease. This test requires oral gallbladder contrast agents. Commonly used contrast agents are iopanoic acid and iodofenamic acid. This drug is mainly excreted by the liver through the bile after being absorbed into the body. Therefore, the bile containing the contrast agent enters the gallbladder from the bile duct After the gallbladder is concentrated, the gallbladder is filled with bile containing a high concentration of contrast agent, which is used for imaging for image observation. Oral cholecystography is suitable for: gallbladder stones, inflammation, tumors, bile duct stones, tumors.

Name: Oral cholecystography

category: X-ray

Oral cholecystogram normal

The normal gallbladder developed better 12-15 h after taking the drug, with a uniform density. The gallbladder is often a dense eggplant-shaped or pear-shaped shadow, 7-10 cm long and about 3-4 cm wide, located below the lower edge of the right upper abdominal liver.

Clinical significance of oral cholecystography

Abnormal results: Oral cholecystography is a method to measure the function of gallbladder condensation. This method can be used to diagnose gallbladder diseases, especially the theoretical basis for diagnosing cholecystitis: (1) both the shape of the gallbladder and the lesions of the gallbladder can be judged, and the function of the gallbladder . (2) Those with suspected gallstone disease but no positive findings in plain film of gallbladder area. (3) The bile duct development rate of the oral method is 50% -70%, which can be developed simultaneously with the gallbladder or 20-40 minutes after the fat meal. People to be checked: those suspected of having gallbladder-related conditions

Precautions for oral cholecystography

Unsuitable population: patients with acute gastroenteritis and pyloric obstruction. Note before the examination: the day before the radiography, take a high-fat diet for lunch and a low-oil diet for dinner. Requirement during the examination: (1) Take the contrast agent from 8 pm on the day before the radiography (0.5 g of iodopanic acid each, 6 tablets in total), and take one tablet every 5 minutes. After taking the medicine, you can drink a small amount of boiling water, take the right side and rest for a while. In addition to drinking water after taking the drug, fast until the end of the test. (2) Take the first film at 8 am the next day (12 hours after taking the medicine). It is best to defecate early in the morning, so that the shadow of the stool does not interfere with the display of the gallbladder. Take a fat meal (two scrambled or poached eggs) if necessary. The film was taken 1 hour after the fat meal to observe the contractile function of the gallbladder.

Other things to note:

1. Patients with severe liver and kidney dysfunction should not be tested repeatedly or double-dose.

2. The second shooting time of the gallbladder condensed image can be determined according to the development situation.

3. To increase the concentration of the contrast agent in the gallbladder, a double dose method can be used.

4. When the contrast of oral contrast is not good, intravenous injection can be used instead.

5. May induce cholecystitis.

Oral cholecystography

The specific method of oral cholecystography is: one day before the radiography, perform abdominal fluoroscopy, pay attention to the calcification of the gallbladder area and biliary tract inflation. Laxatives are generally available to rule out gas accumulation. Take the medicine about 1 hour after the fat dinner the afternoon before the radiography. You can use iopanoic acid or iodofenamic acid, 6 tablets per dose (0.5g each, a total of 3g), can take 1 tablet every 5 minutes, 3g after serving, and then do not eat except a small amount of water. The next day, take a photo 13-14 hours after taking the medicine. If the gallbladder has developed, you can take 3 fried eggs, and then take a photo 30-30 minutes later to observe the gallbladder contraction. Under normal circumstances, the gallbladder can shrink to 1 / 3-1 / 2 of its original volume. If the gallbladder contraction is unsatisfactory, you can postpone another shot at 60 minutes. If the gallbladder does not develop after taking iopanoic acid once, you can take another 6 tablets (that is, double the dose) on the night of the filming, and then take the next day or after 2 weeks, take the double dose and then take the film.

Oral cholecystography- related diseases

Cholelithiasis in the elderly, biliary dyskinesia, postoperative cholecystectomy syndrome, acute cholecystitis in children, cholecystitis in the elderly, secondary choledocholithiasis, gallbladder carcinoid, Mirizzi syndrome, gallbladder stones, benign gallbladder tumor

Symptoms related to oral cholecystography

Gallbladder pain, palate, bloating, bloating, slender uvula, tenderness of gallbladder, lazy gallbladder, gallstones, bloating, abdominal pain, nausea and vomiting

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