Table of Contents
- Gallstones facts
- What are gallstones, and how do they form?
- What are gallstones and how do they form?
- What do gallstones look like?
- What causes gallstones, and who gets them?
- What are the types of gallstones?
- Pigment and other types of gallstones
- Who is at risk for gallstones?
- What are the symptoms of gallstones?
- What are the complications of gallstones?
- What are the complications of gallstones? (Continued)
- What is the relationship of sludge to gallstones?
- What kind of doctor treats gallstones?
- How are gallstones diagnosed?
- How are gallstones diagnosed? (Part 2)
- How are gallstones diagnosed? (Part 3)
- How are gallstones diagnosed? (Part 4)
- How are gallstones diagnosed? (Part 5)
- What are the potential pitfalls of diagnosing gallstones?
- How are gallstones treated?
- Can gallstones be prevented?
- Can symptoms continue after gallstones are removed?
- What's new with gallstones?
What kind of doctor treats gallstones?
Gallstones usually are diagnosed by a gastroenterologist, a medical subspecialist who deals with diseases of the intestine, liver, pancreas and gallbladder. General surgeons also may be involved in the diagnosis of gallstones but usually are the doctors who treat gallstones because the common treatment is surgical removal of the gallbladder.
How are gallstones diagnosed?
Gallstones are diagnosed in one of two situations.
- When there are symptoms or signs that suggest the presence of gallstones and the diagnosis of gallstones is being pursued.
- Coincidentally while a non-gallstone-related medical problem is being evaluated.
Ultrasonography is the most important means of diagnosing gallstones. Standard computerized tomography (CT or CAT scan) and magnetic resonance imaging (MRI) may occasionally demonstrate gallstones; however, they are not as useful compared to ultrasonography because they miss gallstones.
Ultrasonography is a radiological technique that uses high-frequency sound waves to produce images of the organs and structures of the body. The sound waves are emitted from a device called a transducer and are sent through the body's tissues. The sound waves are reflected by the surfaces and interiors of internal organs and structures as "echoes." These echoes return to the transducer and are transmitted onto a viewing monitor. On the monitor, the outline of organs and structures can be determined as well as their consistency, for example, liquid or solid.
There are two types of ultrasonographic techniques that can be used for diagnosing gallstones: transabdominal ultrasonography and endoscopic ultrasonography.
For transabdominal ultrasonography, the transducer is placed directly on the skin of the abdomen. The sound waves travel through the skin and then into the abdominal organs. Transabdominal ultrasonography is painless, inexpensive, and without risk to the patient. In addition to identifying 97% of gallstones in the gallbladder, abdominal ultrasonography can identify many other abnormalities related to gallstones. It can identify:
- A thickened wall of the gallbladder when there is cholecystiti and inflammation has thickened the wall
- Enlarged gallbladder and bile duct due to obstruction by gallstones
- Fluid surrounding the gallbladder (a possible sign of inflammation) sludge
Transabdominal ultrasonography also may identify diseases not related to gallstones that may be the cause of the patient's problem, for example, appendicitis. The limitations of transabdominal ultrasonography are that it can only identify gallstones larger than 4-5 millimeters in size, and it is poor at identifying gallstones in the bile ducts. Continue Reading
UpToDate. Gallstones (Beyond the Basics).
Thistle, J. et al. Factors That Predict Relief From Upper Abdominal Pain After Cholecystectomy. Clinical Gastroenterology and Hepatology, Vol. 9, Issue 10, p891–896. Published online: May 23, 2011.
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