FALSE-NORMAL ORAL CHOLECYSTOGRAM

Abstract

Five case reports of patients who underwent cholecystectomy following normal oral cholecystograms and who were found to have cholelithiasis or acalculous gallbladder disease are presented. Despite the present day 90-95% accuracy of oral cholecystography, there may be occasional pharmacological and mechanical factors contributing to the nonvisualization of biliary calculi. The gallbladder which visualizes normally during cholecystography, on occasion, may contain nonvisualized biliary calculi or may be diseased in the acalculous state, resulting in the so-called false-normal oral cholecystogram. The possible etiology of the false-normal X-ray and several means by which the surgeon may prove or disprove biliary disease are reviewed. The emphasis should be placed on surgical judgment when a patient presents with symptoms of cholelithiasis in the face of normal oral cholecystography.