CHOLECYSTOGRAPHY IN THE PRESENCE OF JAUNDICE

Abstract
Cholecystography in the presence of jaundice is a feasible and helpful procedure in the diagnosis of biliary tract disease. Of the 50 patients examined with iodipamide, a visualized gall-bladder was shown in 21 instances, or 42%. If the series is divided into cases where the serum bilirubin is more than, or less than, 5.0 mg%, disproportionate values are obtained. Eighteen patients, encompassing all types of jaundice, and in whom the serum bilirubin was greater than 5.0 mg%, were examined and the gallbladder was visualized in 3, or about 17%. Of the 8 cases of obstructive jaundice in the more severe degree of hyperbilirubinemia, 2 satisfactory gallbladder examinations were obtained. Likewise, where the degree of icterus was more intense, only 1 of 6 cases of hepatitis revealed a normal gallbladder. Among the 32 patients having serum bilirubin values of less than 5.0 mg%, gallbladder opacification was obtained in 18 cases, or about 56%. In this category, 10 gallbladders (45%) of the 22 cases of obstructive jaundice could be visualized, while in the group of hepatitis, all the 6 cases showed an opacified viscus. The benefits of X-ray examination of the gallbladder and/or common duct in the presence of jaundice are best derived through positive findings. A normally visualized gall-bladder without stones strongly points to intra-hepatic disease as the basis of the jaundice. However, extrahepatic and extrabiliary obstructive phenomena should not be ruled out as a cause of jaundice by such a normal report. Administration of the radioopaque substances appeared to have no ill effects on the patients, nor did it interfere with the course of the disease.