Gallstones

What are gallstones?

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CT gallstones image

Gallstones are solid particles that develop in the gallbladder. Stones form from crystallization of bile, a fluid made by the liver and secreted into the bowel through the bile ducts to help digest fats.

Some gallstones do not produce noticeable symptoms. However, if a gallstone causes blockage of the gallbladder or the bile duct, it can cause inflammation and pain in the right upper abdomen, upper right shoulder or between the shoulder blades, lasting from a few minutes to several hours. Other symptoms include nausea and vomiting, fever, and chills. Inflammation of the gallbladder is called cholecystitis.

How are gallstones evaluated?

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ultrasound gallstone image

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MRI abdomen gallstones image

Imaging is used to provide your doctor with valuable information about gallstones, such as location, size and effect on organ function. Some types of imaging that your doctor may order include:

  • Abdominal ultrasound (www.radiologyinfo.org/en/info.cfm?pg=abdominus): Ultrasound produces pictures of the gallbladder and bile ducts. It shows signs of inflammation or indications that there is blockage of bile flow. Ultrasound is the most common test performed to evaluate gallbladder abnormalities.

    For information about ultrasound procedures performed on children,
    visit the Pediatric Abdominal Ultrasound page (www.radiologyinfo.org/en/info.cfm?pg=abdomus-pdi).

  • Abdominal CT (www.radiologyinfo.org/en/info.cfm?pg=abdominct): CT rapidly produces detailed pictures of the gallbladder and bile ducts to look for signs of inflammation or indications that there is blockage of bile flow. See the Safety page (www.radiologyinfo.org/en/safety/) for more information about CT.
  • Magnetic resonance cholangiopancreatography (MRCP) (www.radiologyinfo.org/en/info.cfm?pg=mrcp): MRCP is an MRI exam that produces detailed images of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. It identifies gallstones and can show gallbladder or bile duct inflammation or blockage. See the Safety page (www.radiologyinfo.org/en/safety/) for more information about magnetic resonance imaging.

How are gallstones treated?

Treatment of gallstones may not be necessary if you do not have symptoms. However, if you have cholecystitis, or if you are having symptoms related to gallstones, the standard treatment is intravenous antibiotics and surgical removal of the gallbladder (cholecystectomy). In most cases, your surgeon will perform a cholecystectomy laparoscopically (with endoscopes placed through small incisions in your abdomen).

If the gallstones have also caused blockage of the biliary ducts, other procedures may be performed, including:

  • Endoscopic retrograde cholangiopancreatography (ERCP) (www.radiologyinfo.org/en/info.cfm?pg=biliary): ERCP is used to examine the bile ducts using an endoscope, a flexible tube that is passed from the mouth through the stomach and into the duodenum. Iodinated contrast material is injected into the bile ducts to locate gallstones that may be causing blockage. Some stones may be successfully removed during ERCP.
  • Percutaneous transhepatic cholangiography (PTC) (www.radiologyinfo.org/en/info.cfm?pg=biliary): PTC is performed by making a small incision on the skin, and advancing a needle into the bile ducts. Iodinated contrast material is injected into the bile ducts to locate gallstones that may be causing blockage. Some stones can be removed during a PTC and others may be bypassed by leaving a catheter or small thin tube in place.

If your doctor decides that you are too sick to undergo surgery, there are other procedures that may be done until surgery can be performed.

  • Cholecystostomy tube placement: A cholecystostomy tube is a small plastic tube (catheter) placed into your gallbladder through a small incision in the skin. The aim of this procedure is to decompress the distended, blocked and inflamed gallbladder by emptying out the backed up, under pressure bile in your gallbladder and diverting it outside the body into a bag attached to the tube. This allows decrease in pain and inflammation in the gallbladder and allows time for the antibiotics to work and for the surgery to be performed at a later date. However, it does not treat the underlying cause (the stones).

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Locate an ACR-accredited provider: To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database.

This website does not provide costs for exams. The costs for specific medical imaging tests and treatments vary widely across geographic regions. Many—but not all—imaging procedures are covered by insurance. Discuss the fees associated with your medical imaging procedure with your doctor and/or the medical facility staff to get a better understanding of the portions covered by insurance and the possible charges that you will incur.

Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic areas.

Outside links: For the convenience of our users, RadiologyInfo.org provides links to relevant websites. RadiologyInfo.org, ACR and RSNA are not responsible for the content contained on the web pages found at these links.

Images: Images are shown for illustrative purposes. Do not attempt to draw conclusions or make diagnoses by comparing these images to other medical images, particularly your own. Only qualified physicians should interpret images; the radiologist is the physician expert trained in medical imaging.

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This page was reviewed on May 16, 2014

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