Diagnosis of gallbladder disease in adults

Contents

The main methods of diagnosing diseases of the gallbladder in adults. Together with gastroenterologists, we will discuss how to check the gallbladder, what procedures and tests should be taken and where they are performed

Diseases of the gallbladder and its ducts are one of the most common pathologies of the digestive system.1. Over the past 10 years in developed countries, the number of patients with cholelithiasis, gallbladder dysfunction and chronic cholecystitis has almost doubled.1. This is due to the lifestyle of modern people who move little and prefer foods high in carbohydrates.1.

Without adequate therapy, disorders of the biliary system often transform into organic pathologies. For example, dysfunction of the gallbladder over time can lead to chronic calculous cholecystitis, which is much more difficult to treat.1. Timely diagnosis of the gallbladder allows you to identify the problem at an early stage, prevent complications and stop the development of the disease.

We asked our experts about current methods for diagnosing gallbladder diseases. Experts told when to see a doctor and where to check the gallbladder, what tests to take and how to properly prepare for the examination.

Why and when to check the gallbladder

The condition of the gallbladder is checked to identify functional disorders and organic pathologies. Thanks to timely diagnosis, it is possible to detect cholecystitis, cholangitis, cholelithiasis, benign and malignant neoplasms at an early stage.3. You can take tests and undergo an examination in medical laboratories, public and private clinics.

Checking the gallbladder with tests and examinations is recommended for people who have noticed the following symptoms:2:

  • sharp or aching pain in the right hypochondrium, which may radiate to the right shoulder or under the right shoulder blade;
  • bitterness in the mouth in the morning or after eating fried, fatty and spicy foods;
  • nausea, often combined with flatulence and decreased appetite, and sometimes with bouts of vomiting;
  • yellowness of the skin and whites of the eyes;
  • temperature increase;
  • skin itching, which is sometimes accompanied by a rash.

Nausea and vomiting, combined with severe pain, usually indicate an acute condition, such as an attack of biliary colic or peritonitis due to cholecystitis. In this case, a person needs urgent medical care up to surgical intervention.

Methods for diagnosing the gallbladder

For the diagnosis of diseases of the gallbladder, laboratory and instrumental methods are used. However, much can be learned already at the stage of visual inspection. The doctor listens to the patient’s complaints, performs palpation and percussion of the gallbladder and makes a preliminary diagnosis.2. Sometimes during the examination it turns out that the pain syndrome is not associated with the state of the biliary tract, but is caused by pathologies of the spine, a viral infection, or a neurological disease.

After the examination, the doctor prescribes tests and examinations for a comprehensive diagnosis of the gallbladder. Diagnostic methods are selected taking into account the symptoms of a particular patient.

Gallbladder ultrasound

Ultrasound examination is considered the most informative method for diagnosing diseases of the gallbladder. Ultrasound is prescribed for pain in the right hypochondrium, bitterness in the mouth, as well as against the background of taking potent drugs and with deviations in laboratory tests3. Scanning allows you to study the anatomical features of the gallbladder and ducts, detect sand, stones and neoplasms.

Ultrasound examination is safe and has no absolute contraindications. The method is not used only if the patient has wounds and scars on the skin of the abdomen that will prevent contact with the ultrasound probe.

MRI of the gallbladder

Magnetic resonance imaging can detect stones, anomalies in the structure of the gallbladder, oncological and inflammatory processes. The study is prescribed for cholangitis, cholecystitis, cholelithiasis, suspicion of the presence of polyps and malignant tumors.

MRI helps to detect the first signs of pathology, for example, neoplasms several millimeters in size. The method has a minimum number of contraindications, including pregnancy, weight over 120 kg and the presence of metal implants in the body.

CT scan of the gallbladder

Computed tomography is used as an additional method for diagnosing diseases of the gallbladder. Most often, CT is prescribed for an atypical clinical picture and in order to exclude alternative diagnoses. During the examination, the doctor can detect an inflammatory process, dense stones, tumors and abscesses. For better visualization, the patient is injected with a radiopaque substance.

CT involves radiation exposure to the body, so it is not prescribed for pregnant women, people with hyperthyroidism, severe pathologies of the liver and kidneys.

duodenal sounding

With the help of probing, the patency of the bile ducts, the rate of contraction of the gallbladder, the presence of an inflammatory process and parasitic invasion are assessed. During the examination, the patient swallows a thin tube through which bile will flow. After the procedure is completed, the collected bile is sent for microscopic and biochemical examination.

Currently, duodenal sounding is rarely used due to the presence of a large number of alternative methods. Probing is contraindicated in people with cholelithiasis, cardiovascular insufficiency, stomach and duodenal ulcers.

MSCT of the abdominal organs

MSCT or multislice computed tomography is used as an additional diagnostic method. MSCT is prescribed for an atypical course of the disease and for lesions of organs that are associated with the gallbladder. This is primarily the pancreas, liver and large intestine.

Endoscopic ultrasound

Intraluminal scanning of the gallbladder with an endoscope. The method allows you to explore inaccessible areas, such as the bile ducts. During the study, tumors, polyps, adenomyosis, narrowing of the ducts, stones and sand can be detected.

Assays

Tests help check the gallbladder. The patient is prescribed a general blood and urine test, as well as a biochemical blood test. Using biochemical analysis, the level and activity of the following enzymes and pigments is determined:

  • aspartate aminotransferase (AST) and alanine aminotransferase (ALT);
  • total bilirubin;
  • alkaline phosphatase or alkaline phosphatase;
  • CPK, creatinine phosphokinase;
  • LDH is lactate dehydrogenase.

With the help of tests, the condition of the gallbladder and other organs is checked, inflammatory processes, violations of the outflow of bile, damage to liver cells are detected. To exclude the pathology of the pancreas, the level of alpha-amylase and lipase is evaluated. Sometimes, if the diagnosis is difficult, indicators of kidney function – urea and creatinine – are also required.

Preparing an Adult for a Gallbladder Diagnosis

All examinations are performed on an empty stomach – at least 6 hours should pass from the moment of the last meal. Before an ultrasound, milk, legumes, carbonated drinks and other foods that cause flatulence are excluded from the diet. Sometimes a doctor may prescribe absorbents.

A few days before duodenal sounding, they begin to follow a diet and stop taking medications: laxatives, choleretic, vasodilators. Before the procedure, mineral water with xylitol is usually drunk to increase the secretion of bile.

Popular questions and answers

Gallbladder diseases are becoming more common, even in young patients (18–35 years). Therefore, many are interested in what tests need to be taken to check the gallbladder.. Our experts answer questions about the diagnosis of gallbladder diseases: therapist, gastroenterologist Abdul Gamidov and PhD, gastroenterologist-hepatologist Olga Arisheva.

Where is the gallbladder located?

The gallbladder is located on the right in the abdominal cavity, most often under the liver, along the right costal arch, and partially comes into contact with the anterior wall of the abdomen. The spatial arrangement of the gallbladder in the abdominal cavity depends on the age and physique of the person.

How to find out if the gallbladder or any other organ hurts?

In diseases of the gallbladder, patients complain of pain in the right hypochondrium. The problem is that similar sensations occur in some diseases of the stomach and intestines. However, pain in gallbladder pathologies is usually associated with nutritional errors.

If a person’s right side hurts after fried, fatty, spicy or smoked foods, then most likely the problem is in the gallbladder. With biliary dyskinesia, attacks of pain often occur on the background of stress and after taking certain medications (estrogens, somatostatin)1,2.

Nevertheless, it is not worth doing self-diagnosis and, moreover, prescribing treatment for yourself. This is ineffective, and in some cases life-threatening. Pain and discomfort in the right hypochondrium is a reason to see a doctor as soon as possible.

Which doctor checks the gallbladder?

In chronic and mild forms of the disease, a gastroenterologist is engaged in treatment and observation. In severe cases (large stones or movement of stones through the gallbladder), a surgeon may be involved. In this case, options for surgical intervention will be considered – perhaps emergency or planned removal of the damaged organ.
  1. Diseases of the biliary tract. Tutorial. Irkutsk ISMU 2020.
  2. Clinic and diagnosis of diseases of the biliary tract and pancreas. Educational-methodical recommendations. Prof. A. V. TKACHEV Rostov State Medical University. http://rostgmu.ru/wp-content/uploads/2020/03/%D0%9C%D0%95%D0%A2%D0%9E%D0%94%

    D0%98%D0%A7%D0%9A%D0%90_%D0%97%D0%96%D0%9F_%D0%A5%D0%9F.pdf

  3. Methods of examination of patients with pathology of the gallbladder.
  4. Clinical guidelines. Treatment of cholecystitis. http://www.gastro.ru/userfiles/R_%D0%9B%D0%B5%D1%87%D0%B5%

    D0%BD%D0%B8%D0%B5%20%D1%85%D0%BE%D0%BB%D0%B5%D1%

    86%D0%B8%D1%81%D1%82%D0%B8%D1%82%D0%B0.pdf

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