How to Diagnose Cholelithiasis

Cholelithiasis is the presence of concretions in the bile duct or gall bladder, commonly known as gallstones. They can cause inflammation of the mucosa in the gall bladder, resulting in chronic cholecystitis. If a gallstone obstructs the cystic duct, the gall bladder can become distended and even necrotic. The gallstone may also get through the cystic duct and block the biliary ductal system. Here's how to diagnose cholelithiasis.

Instructions

• 1

  Consider cholelithiasis in children with intermittent abdominal pain and associated risk factors such as trauma to the gall bladder or prolonged fasting. The pain may be centered in the upper right quadrant and accompanied by jaundice.

• 2

  Conduct a physical examination including auscultation and palpation. Pain in the right subcostal area upon palpation during inhalation is characteristic of cholelithiasis. A swollen liver or spleen may indicate a predisposition to gallstones.

• 3

  Run laboratory studies to measure liver functioning. These results are typically in the normal range and are performed to differentiate cholelithiasis from a disease of the biliary tract or gall bladder. Transaminase and transpeptidease levels may be slightly elevated.

• 4

  Perform ultrasound as the imaging study of choice for cholelithiasis. This technique can locate the gallstone and detect a thickening of the gall bladder and the presence of pericholecystic fluid.

• 5

  Use a magnetic resonance cholangiopancreatography (MRCP) in pediatric patients when complications of the liver and bile system are suspected. This technique is promising as a noninvasive method of examining the bile and pancreatic systems, but is not always available.