Gallstone disease other diagnostic studies: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Gallstone disease}} | {{Gallstone disease}} | ||
{{ | {{CMG}}; {{AE}} {{HM}} | ||
==Overview== | ==Overview== | ||
Bile microscopy has been largely replaced by transabdominal [[ultrasound]], however it may be helpful in evaluating [[Obesity|obese]] patients. Other tests may be indicated depending upon the patient's symptoms and history to rule out other differential diagnoses. | |||
== Other | ==Other Imaging Findings== | ||
===Bile microscopy=== | |||
*Patients who exhibit symptoms of [[Gallstone disease history and symptoms|biliary colic]] and [[ultrasound]] fails to detect stones often turn to microscopic analysis of their bile as proof of microlithiasis.<ref name="pmid3943777">{{cite journal |vauthors=Delchier JC, Benfredj P, Preaux AM, Metreau JM, Dhumeaux D |title=The usefulness of microscopic bile examination in patients with suspected microlithiasis: a prospective evaluation |journal=Hepatology |volume=6 |issue=1 |pages=118–22 |year=1986 |pmid=3943777 |doi= |url=}}</ref><ref name="pmid3706246">{{cite journal |vauthors=Moskovitz M, Min TC, Gavaler JS |title=The microscopic examination of bile in patients with biliary pain and negative imaging tests |journal=Am. J. Gastroenterol. |volume=81 |issue=5 |pages=329–33 |year=1986 |pmid=3706246 |doi= |url=}}</ref><ref name="pmid7366692">{{cite journal |vauthors=Sedaghat A, Grundy SM |title=Cholesterol crystals and the formation of cholesterol gallstones |journal=N. Engl. J. Med. |volume=302 |issue=23 |pages=1274–7 |year=1980 |pmid=7366692 |doi=10.1056/NEJM198006053022302 |url=}}</ref><ref name="pmid6884818">{{cite journal |vauthors=Gollish SH, Burnstein MJ, Ilson RG, Petrunka CN, Strasberg SM |title=Nucleation of cholesterol monohydrate crystals from hepatic and gall-bladder bile of patients with cholesterol gall stones |journal=Gut |volume=24 |issue=9 |pages=836–44 |year=1983 |pmid=6884818 |pmc=1420078 |doi= |url=}}</ref> | |||
*It has an overall sensitivity of 65 - 90% for identifying patients with gallstones. | |||
*The test detects traces of [[cholesterol]] crystals or [[Bilirubin|bilirubinate]] granules. | |||
*A high number of patients whom had clear [[ultrasounds]] had positive results on microscopy, however, the high [[Sensitivity (tests)|sensitivity]] of tranabdominal [[Medical ultrasonography|ultrasonography]] has made the need for microscopy rare. | |||
===Other Tests=== | |||
*Upper [[endoscopy]] to look for [[Peptic ulcer|peptic ulcer disease]].<ref name="pmid15802102">{{cite journal |vauthors=Shaffer EA |title=Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? |journal=Curr Gastroenterol Rep |volume=7 |issue=2 |pages=132–40 |year=2005 |pmid=15802102 |doi= |url=}}</ref><ref name="pmid26895902">{{cite journal |vauthors=Julliard O, Hauters P, Possoz J, Malvaux P, Landenne J, Gherardi D |title=Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors |journal=Surg Endosc |volume=30 |issue=10 |pages=4539–43 |year=2016 |pmid=26895902 |doi=10.1007/s00464-016-4790-4 |url=}}</ref> | |||
*Endoscopic [[Medical ultrasonography|ultrasonography]] to look for [[chronic pancreatitis]]. | |||
*[[Endoscopic retrograde cholangiopancreatography|Endoscopic retrograde cholangiopancreatography (ERCP)]] with [[sphincter of Oddi]] [[Pressure measurement|manometry]] to look for [[sphincter of Oddi dysfunction]]. | |||
*[[HIDA scan|Cholescintigraphy]] with or without [[cholecystokinin]] (CCK)-stimulation to look for [[acute cholecystitis]] and functional gallbladder disorder, respectively. | |||
*Testing for [[Coronary heart disease|ischemic heart disease]]. | |||
*[[Esophageal motility study|Esophageal manometry]] to look for [[esophageal]] sources of [[chest pain]], such as [[Diffuse esophageal spasm (patient information)|esophageal spasm]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Hepatology]] | [[Category:Hepatology]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category: | [[Category:Disease]] | ||
[[Category: | [[Category:Radiology]] | ||
Latest revision as of 21:48, 29 July 2020
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Gallstone disease other diagnostic studies On the Web |
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Risk calculators and risk factors for Gallstone disease other diagnostic studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Bile microscopy has been largely replaced by transabdominal ultrasound, however it may be helpful in evaluating obese patients. Other tests may be indicated depending upon the patient's symptoms and history to rule out other differential diagnoses.
Other Imaging Findings
Bile microscopy
- Patients who exhibit symptoms of biliary colic and ultrasound fails to detect stones often turn to microscopic analysis of their bile as proof of microlithiasis.[1][2][3][4]
- It has an overall sensitivity of 65 - 90% for identifying patients with gallstones.
- The test detects traces of cholesterol crystals or bilirubinate granules.
- A high number of patients whom had clear ultrasounds had positive results on microscopy, however, the high sensitivity of tranabdominal ultrasonography has made the need for microscopy rare.
Other Tests
- Upper endoscopy to look for peptic ulcer disease.[5][6]
- Endoscopic ultrasonography to look for chronic pancreatitis.
- Endoscopic retrograde cholangiopancreatography (ERCP) with sphincter of Oddi manometry to look for sphincter of Oddi dysfunction.
- Cholescintigraphy with or without cholecystokinin (CCK)-stimulation to look for acute cholecystitis and functional gallbladder disorder, respectively.
- Testing for ischemic heart disease.
- Esophageal manometry to look for esophageal sources of chest pain, such as esophageal spasm.
References
- ↑ Delchier JC, Benfredj P, Preaux AM, Metreau JM, Dhumeaux D (1986). "The usefulness of microscopic bile examination in patients with suspected microlithiasis: a prospective evaluation". Hepatology. 6 (1): 118–22. PMID 3943777.
- ↑ Moskovitz M, Min TC, Gavaler JS (1986). "The microscopic examination of bile in patients with biliary pain and negative imaging tests". Am. J. Gastroenterol. 81 (5): 329–33. PMID 3706246.
- ↑ Sedaghat A, Grundy SM (1980). "Cholesterol crystals and the formation of cholesterol gallstones". N. Engl. J. Med. 302 (23): 1274–7. doi:10.1056/NEJM198006053022302. PMID 7366692.
- ↑ Gollish SH, Burnstein MJ, Ilson RG, Petrunka CN, Strasberg SM (1983). "Nucleation of cholesterol monohydrate crystals from hepatic and gall-bladder bile of patients with cholesterol gall stones". Gut. 24 (9): 836–44. PMC 1420078. PMID 6884818.
- ↑ Shaffer EA (2005). "Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century?". Curr Gastroenterol Rep. 7 (2): 132–40. PMID 15802102.
- ↑ Julliard O, Hauters P, Possoz J, Malvaux P, Landenne J, Gherardi D (2016). "Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors". Surg Endosc. 30 (10): 4539–43. doi:10.1007/s00464-016-4790-4. PMID 26895902.