1. Ultrasonography
After a thorough history and complete physical exam, including checking the abdomen for tenderness and checking for jaundice in your skin or the whites of your eyes, your health care provider may order one or more tests to confirm a suspected diagnosis of gallstones. Ultrasonography (ultrasound) uses sound waves instead of X-rays to create an image of the body. Ultrasound is considered the most reliable way to find gallstones in the gallbladder and can occasionally find them in the common bile duct.
2. Computerized Tomography (CT) Scan
With this method, a complete view of the internal organs can be seen by using a series of x-rays that are created by a computer. The test is not painful or invasive in any way. The scan does deliver radiation---labeled moderate to high---although the amounts vary with what testing is done. Speak with your health care provider if you have concerns about the levels of radiation exposure during a CT scan.
3. Radionuclide Scan
You will need to have a peripheral (typically on the upper limbs) intravenous line placed before the scan. A small amount of radioactive tracer material is injected into your veins through your IV line into your blood stream. A scan of the gallbladder is then done to track the radioactive tracing substance as it travels through your body. If the substance is unable to reach the gallbladder it indicates a blockage at the opening of the gallbladder or the cystic duct, likely being caused by a gallbladder stone.
4. Endoscopic Retrograde Cholangiopancreatography (ERCP)
A bendable instrument that is lighted and capable of passing video images (an endoscope) is passed down your throat, through your stomach and into the duodenum, or small intestine. Your physician may use pockets of air to help inflate your intestinal tract so that a better view of the bile and pancreatic duct openings can be seen. Once clearly visible, dye is injected into the ducts through a small tube on the endoscope. X-rays are taken and if a stone is spotted, the physician can then use a specialized instrument to try and remove the stone. This test can also be done as a magnetic resonance cholangiopancreatography, which is a similar procedure, without the option of removing a discovered stone.
5. Endoscopic Ultrasound (EUS)
If your provider suspects that gallstones are positioned in the common bile duct, this test, which is less invasive than an ERCP, may be performed. Again, an endoscope is used in this procedure. An ultrasound transducer is positioned on the endoscope at the tip. The endoscope is passed thru the throat toward the common bile duct in the same manner as when done with an ERCP. Very clear images can be taken with the ultrasound because the ultrasound transducer is so much closer to the problem area. This procedure is used only for diagnosing gallbladder stones. If a stone is found that needs to be removed, additional treatment will need to be done.
