Cholecystography is a technique of radiopaque examination of the condition of the gallbladder. Cholecystography is performed to determine the position, size, shape, contours, structure and functional state of the gallbladder. Cholecystography is informative for detecting deformities, concretions, inflammation, cholesterol polyps, gallbladder tumors, etc. Contrast agents (organic iodine compounds) can be taken by the patient orally, injected intravenously, less often through a probe into the duodenum. Targeted cholecystograms (with and without compression of the gallbladder) are performed after survey images, sometimes against the background of taking a choleretic breakfast.
Indications
There are a number of conditions (including depression of the concentration function of the biliary tract) that may arouse suspicion in the attending physician. In this case, one of the methods of cholecystography is prescribed to make a correct diagnosis or clarify an existing one. In various situations, the specialist selects the most rational method of X-ray examination of the gallbladder and bile ducts.
- Biliary dyskinesia. This disease is characterized by a disorder of the motor function of the gallbladder and biliary tract. This contributes to the disruption of the natural outflow of bile into the duodenum, which is accompanied by an incorrect digestion process and is manifested by characteristic symptoms.
- Suspected cholelithiasis. In situations where there are characteristic symptoms of cholecystitis and a specialist has good reasons to suspect cholelithiasis, cholecystography may be prescribed (what is it, described above) to determine the presence or absence of concretions.
- Study of the state of the biliary system in tumors. Tumors of various genesis, localized near the organs of the biliary system, can rapidly progress and rapidly increase in size. Over time, this can lead to partial or complete compression of the bile ducts and a slowdown or complete cessation of the flow of bile. This condition is fraught with the development of serious complications, the fight against which is not always favorable.
- Frequent pains in the right hypochondrium that are not eliminated by medications. Frequent periodic pain in the right hypochondrium may indicate the presence of various pathologies of the biliary system. It is worth noting that the localization of pain in this area is due to the projection of the gallbladder and outflow ducts into the right hypochondrium.
- Violation of the digestion of fats in the intestine. A symptom characteristic of the pathology of the organs of the biliary system, because bile causes the digestion of fats in the cavity of the digestive tract.
What shows
These methods of X-ray diagnostics are highly informative in nature and are able to provide the necessary information for making a correct diagnosis. The following are some data that can be obtained after cholecystography or intravenous cholegraphy.
- The shape of the bubble, its size. The shape and size of the bubble reflect its functional abilities. Their deviation from normal indicators may be a sign of the development of pathologies.
- Correct position. The correct anatomical position of these structures and nearby organs prevents pathological compression of the excretory ducts.
- Relief of the inner wall. Sometimes it is possible to determine various deviations in the state of the internal wall of the organ: the growth and development of polyps, etc.
- Availability of additional inclusions. On the X-ray it is possible to detect the presence of additional inclusions – calcifications. This may indicate the development of cholelithiasis.
- Contractility of the gallbladder. This function affects the intensity of bile excretion and further processing of the food lump.
Preparation
Preparation for cholecystography is integral and important.
For 1-2 days, it is recommended to exclude from the diet all foods that stimulate the formation of gases in the gastrointestinal tract (dairy, meat and legumes).
The day before, 1 day before the study, the last meal should not be later than 19:00.
1 day before the procedure and directly on the day of manipulation, preparation for the study (cholecystography) implies the rejection of drugs that affect motility and the intensity of bile production (only after consultation and appointment of a specialist). This may distort the data obtained.
Before cholecystography, the doctor prescribes a special meal that stimulates the secretion of bile.
Proper preparation of the patient for cholecystography will provide reliable data that will help to find out the cause of complaints and establish a diagnosis.
Methods of conducting
The procedure is carried out in a specially equipped X-ray room. Depending on the X-ray method, a contrast agent is administered orally or parenterally to the patient over a certain period of time. Next, a series of pictures are taken. After their manifestation, it remains to wait for the decoding and analysis of the results obtained.
Contraindications
Let’s consider the main contraindications to cholecystography.
- Jaundice. Jaundice is often a symptom of pathological processes developing in the liver. This organ plays one of the most important roles – detoxification. The introduction of a contrast agent can only aggravate the situation.
- Cirrhosis of the liver. Cirrhosis of the liver, in which there is a persistent and serious violation of the function of this organ, is also a contraindication to the examination. The essence is similar to the previous contraindication: violation of the detoxification function of the liver after contrast administration.
- Acute cholangitis. This pathological condition is characterized by the development of inflammatory processes in the bile ducts of the liver due to the action of various infectious agents.