Gallbladder Diagnosis

Gallbladder diagnosis aims to identify gallbladder diseases such as gallstones (cholelithiasis), gallbladder inflammation (cholecystitis), or gallbladder cancer.

The following is a general outline for the diagnosis of gallbladder diseases:

Patient History

The clinician will typically start with a thorough medical history. They will ask about the patient's symptoms, duration of symptoms, diet, lifestyle, and personal or family history of gallbladder disease.

Physical Examination

The doctor will perform a physical examination that may include feeling the upper abdomen for signs of gallbladder inflammation, such as tenderness or swelling. They may also check for signs of jaundice (yellowing of the skin and the whites of the eyes).

Blood Tests

Blood tests may be performed to detect signs of infection, liver problems, pancreatitis, or other abnormalities. Blood tests can also determine if there is an increased white blood cell count, which may suggest an infection or inflammation.

Imaging Tests

Imaging tests can help visualise gallstones, inflammation, or tumours in the gallbladder. These may include:

• Ultrasound is often the first imaging test used in suspected gallbladder disease. It uses sound waves to create images of the gallbladder and can detect gallstones, thickening or swelling of the gallbladder wall, or fluid around it.
• Computed Tomography (CT) Scan: This scan can provide a more detailed image of the gallbladder and surrounding structures. It can be useful for detecting complications of gallstones or tumours.
• Magnetic Resonance Imaging (MRI): An MRI provides detailed images and can detect more subtle abnormalities or complications, such as a bile duct blockage.
• HIDA Scan (Hepatobiliary Iminodiacetic Acid Scan): This test can be used when suspected of gallbladder disease, but ultrasound results are unclear. It involves injecting radioactive material into the body, which is then tracked using a special camera to show how well the gallbladder functions and if there are any blockages in the bile ducts.

Endoscopic Tests

• Endoscopic Retrograde Cholangiopancreatography (ERCP): This procedure can diagnose and treat certain conditions. A flexible tube (endoscope) is passed down the patient's throat, through the stomach, and into the top part of the small intestine. A dye is then injected into the bile ducts through the endoscope, making blockages visible on X-rays.
• Endoscopic Ultrasound (EUS): An endoscope places an ultrasound probe close to the gallbladder, providing highly detailed images and guiding fine-needle aspiration for biopsies.

Biopsy

If gallbladder cancer is suspected, a biopsy may be performed. This involves removing a small tissue sample from the gallbladder for examination under a microscope.

Remember that not all these tests may be necessary for every patient, and the exact approach will depend on the patient's symptoms, physical exam findings, medical history, and the results of initial tests.