How are gallstones diagnosed?

Frequently, gallstones are discovered during tests for other health conditions. When gallstones are suspected, the doctor is likely to do an ultrasound exam -- the most sensitive and specific test for gallstones. A handheld device, which a technician glides over the abdomen, sends sound waves toward the gallbladder. The sound waves bounce off the gallbladder and other organs, and their echoes make electrical impulses that create a picture of the gallbladder on a video monitor. If gallstones are present, the sound waves will bounce off them, too, showing their location. Other tests are as follows:

Computerized tomography (CT) scan: The CT scan is a non-invasive x-ray that produces cross-section images of the body. The test may show the gallstones or complications, such as infection and rupture of the gallbladder or bile ducts.

Cholescintigraphy (HIDA scan): The patient is injected with a small amount of non-harmful radioactive material that is absorbed by the gallbladder, which is then stimulated to contract. The test is used to diagnose abnormal contraction of the gallbladder or obstruction of the bile ducts.

Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is used to locate and remove stones in the bile ducts. After lightly sedating you, the doctor inserts an endoscope -- a long, flexible, lighted tube with a camera -- down the throat and through the stomach and into the small intestine. The doctor guides the endoscope and injects a special dye that helps the bile ducts appear better on a video monitor. The endoscope helps the doctor locate the gallstone. The stone is captured in a tiny basket and removed with the endoscope.

Blood tests: Blood tests may show signs of infection, obstruction, pancreatitis, or jaundice.

Since gallstone symptoms may be similar to those of a heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, and hepatitis, an accurate diagnosis is important.

This answer is based on source information from National Institute of Diabetes and Digestive and Kidney Diseases.

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Medical tests that are used to diagnose gallstones -- pebble-like deposits in the gallbladder -- include the following:

• Ultrasound. Abdominal ultrasounds are the most widely used tests because they are 98% accurate in detecting gallstones. Ultrasound may also pick up other problems related to the gallstones such as swelling and thickening of the gallbladder wall.
• Computed Tomography (CT) Scans. Doctors may do abdominal CT scans to evaluate the bile ducts connected to the gallbladder and to note any swelling of the gallbladder or pancreas. CT scans usually are not as accurate as ultrasound at detecting gallstones.
• Nuclear medicine scan. This test uses iminodiacetic acid to determine whether any of the bile ducts are obstructed with gallstones.
• MRI. Magnetic resonance imaging can be used to further evaluate the ductal system, and to get clear images of the pancreas to look for signs of swelling or other problems.

Blood tests to check levels of bile pigment (bilirubin), pancreatic enzymes and liver function may also be ordered.