Understand the diagnostic process for gallstones. Learn about ultrasound, HIDA scans, and the clinical evaluations used to confirm a diagnosis of cholelithiasis.
Send us all your questions or requests, and our expert team will assist you.
Diagnosis and Evaluation
The path to a definitive diagnosis begins with a comprehensive clinical consultation. When you visit a specialist at Liv Hospital, the process starts with a detailed medical history where you describe the nature, location, and timing of your pain. A physical examination is then performed, focusing on the “Murphy Sign.” This involves the doctor applying pressure to your upper right abdomen while you take a deep breath. If the gallbladder is inflamed, it will touch the doctor’s hand as you breathe in, causing sharp pain and a sudden stop in the breath. This simple physical test is a strong initial indicator of gallbladder disease.
An abdominal ultrasound is the “gold standard” and most common diagnostic tool for identifying stones. It is non invasive, painless, and uses sound waves to create images of your internal organs.
During the ultrasound, the technician will also check the width of the bile ducts to see if any stones have moved out of the organ and into the passage toward the intestine.
In some clinical cases, a standard ultrasound may not provide enough detail, especially if the patient is overweight or has significant intestinal gas. An endoscopic ultrasound involves passing a thin, flexible tube (endoscope) through the mouth and into the digestive tract.
A small ultrasound probe at the tip of the tube allows the specialist to look at the gallbladder and bile ducts from inside the body. This provides much higher resolution images and is particularly useful for finding very small stones or “sludge” that might be missed by external imaging.
A CT scan uses X-rays to create cross sectional images of the body. While it is not the primary tool for finding the stones themselves (as some cholesterol stones have the same density as bile and are “invisible” on CT), it is excellent for identifying complications.
In an emergency setting, a CT scan is often the first imaging performed to get a broad overview of the entire abdominal cavity and ensure no life threatening complications are present.
A HIDA scan is a specialized nuclear medicine test that evaluates the function of the gallbladder rather than just its appearance. A small amount of radioactive tracer is injected into a vein. The liver absorbs this tracer and sends it into the bile.
This test is vital for diagnosing “acalculous” gallbladder disease or identifying a blockage when the stones are too small to be seen on a regular ultrasound. It provides a dynamic view of how bile moves through your system.
MRCP is a specialized type of MRI that focuses specifically on the biliary and pancreatic ducts. It is a non invasive alternative to more traditional procedures.
At Liv Hospital, we utilize the latest MRI technology to ensure that if a stone has migrated, we know its exact location before any treatment or surgery is planned.
ERCP is a procedure that is both diagnostic and therapeutic. It involves using an endoscope and X-ray dye to look at the bile ducts.
Because it is more invasive and carries a small risk of triggering pancreatitis, ERCP is usually reserved for patients where stones in the bile duct are highly suspected or confirmed by other imaging like MRCP.
While imaging shows the physical stones, blood tests provide information about how the condition is affecting your body’s chemistry.
These tests help the clinical team at Liv Hospital determine the urgency of your care and whether you require intravenous antibiotics before any procedure.
Because abdominal pain can have many sources, a critical part of the evaluation is ruling out other conditions.
Our multidisciplinary team ensures that every potential cause is considered, providing you with the peace of mind that your diagnosis is accurate and that your treatment is targeted to the correct organ.
To ensure the most accurate results, patients are usually asked to follow specific clinical protocols before their appointments. For most abdominal imaging, you will need to fast (nothing to eat or drink) for at least six to eight hours. This ensures the gallbladder is full of bile and distended, making it much easier for the ultrasound or MRI to capture clear details. Our staff at Liv Hospital will guide you through every step of the preparation, ensuring that your diagnostic evaluation is smooth, efficient, and leads to the best possible clinical outcome.
Send us all your questions or requests, and our expert team will assist you.
They are diagnosed primarily through imaging that shows stones in the gallbladder or bile ducts.
Yes. Many gallstones are found incidentally during evaluation for other reasons.
No. Blood tests support evaluation but cannot detect stones directly.
Imaging is usually required to confirm gallstones and assess their location.
No. Many gallstones remain harmless and never cause symptoms.
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