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A diagnostic workup is based on the most likely diagnosis. In testing for gallbladder disease, specifically, liver panel tests and pancreatic enzymes such as lipase will be within normal limits. There can be a mild elevation in alkaline phosphatase and bilirubin in some instances, such as cholecystitis.
Cholescintigraphy or hepatobiliary scintigraphy is scintigraphy of the hepatobiliary tract, including the gallbladder and bile ducts.The image produced by this type of medical imaging, called a cholescintigram, is also known by other names depending on which radiotracer is used, such as HIDA scan, PIPIDA scan, DISIDA scan, or BrIDA scan.
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
Once tissue has died, the gallbladder is at greatly increased risk of rupture (perforation), which can cause sharp pain. Rupture can also occur in cases of chronic cholecystitis. [13] Rupture is a rare but serious complication that leads to abscess formation or peritonitis. [14] Massive rupture of the gallbladder has a mortality rate of 30%. [13]
The CCK test may be administered in conjunction with an ultrasound test to visually monitor gall bladder contraction. While the test is usually administered in a supine position Dr. William Smedley of Wilkes Barre, Pennsylvania has detected previously missed gallbladder abnormalities by administering the test in an erect position. [2] [3] [4]
Blood work, including a thyroid test and hormone test, can help doctors figure out the best course of action. So can active listening. “Communication skills are absolutely critical in this ...
Failure of gallbladder visualisation during oral cholecystography when abnormal liver function returns to normal, or there is mild to moderate liver disease, maybe due to extrahepatic (outside the liver) causes. [4] Oral cholecystography can have better sensitivity and specificity in diagnosing acute and chronic gallbladder disease than ultrasound.
Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is primarily performed by highly skilled and specialty trained gastroenterologists.