Ultrasound scanning is the best method for diagnosing gallstones in the gallbladder. Cholecystography also is effective. With cholecystography, an x-ray shows the path of a radiopaque contrast substance as it is swallowed, absorbed in the intestine, secreted into the bile, and stored in the gallbladder. If the gallbladder isn't funetioning, the contrast material won't show up in the gallbladder. If the gallbladder is functioning,the outline of the galistone is revealed in the X-rays by the contrast msterial. By using ultrasound and cholecystography together, a doctor can identify gallstones in the gallbladder 98 percent of the time. However, the tests may give false-positive results in a few people who don't have gallstones.

When a person has abdominal pain, jaundice, chills, and a fever, gallstones in the bile duct are a strong possibility. Blood test results usually show a pattenn of abnormal liver function that suggests bile duct obstruction. Several tests cun prvide the additional information needed to make a firm diagnosis. These include ultrasound scans, computed tomography (CT), and various x-raу techniques using a radiopaque contrast substance to outline the bile ducts. Ultrasound scanning and CT cun show whether the bile duct is dilated, but the ducts can be obstructed without being dilated. The X-ray techniques help detect an obstruction and, if present, whether it is caused by a gallstone.

Which diagnostic X-ray technique is used depends on the situation. If the diagnosis is fairly certain, many doctors perform one of the X-ray techniques before deciding on surgery. If the diagnosis is uncertain, ultrasound scanning may be performed first.

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