What is a HIDA scan? How do doctors diagnose gallbladder problems? Explore the various diagnostic tests for gallbladder disease, from ultrasounds to MRIs, and discover how they are used to identify issues with this important organ.

Understanding Gallbladder Disease

The gallbladder, a sac located near the liver, serves as a storage space for bile. Unfortunately, this organ can be plagued by a variety of problems, such as gallbladder cancer, inflammation (cholecystitis), and gallstones. Gallbladder disease is the term used to describe these maladies, and in many cases, individuals may not experience any symptoms at all, with up to 90 percent of people with gallstones being asymptomatic.

When Diagnostic Tests Are Necessary

Doctors typically only order diagnostic tests for gallbladder problems when a patient is experiencing symptoms. These warning signs can include severe pain in the right upper abdomen, pain after eating high-fat foods, fever with shaking and chills, nausea, vomiting, heartburn, indigestion, and a feeling of fullness in the abdomen. However, even if a person is not experiencing symptoms, doctors may still spot signs of gallbladder problems during diagnostic testing for other conditions.

Eliminating Other Causes

Before ordering specific tests for the gallbladder, doctors will first ask detailed questions about the patient’s symptoms and perform a physical examination. They will also try to eliminate other possible causes of the patient’s abdominal pain, such as irritable bowel syndrome, Crohn’s disease, pancreatitis, kidney stones, and even pneumonia.

Diagnostic Imaging Tests

Once other potential causes have been ruled out, the doctor will likely order one or more imaging tests to examine the gallbladder more closely. These tests include ultrasounds, X-rays, CT scans, MRI scans, and endoscopic retrograde cholangiopancreatography (ERCP).

Ultrasound

Ultrasound is the most commonly used diagnostic test for gallbladder problems, as it is effective at identifying even very small gallstones. However, it may not always clearly diagnose cholecystitis, or inflammation of the gallbladder.

X-rays

Abdominal X-rays can spot gas and some types of gallstones containing calcium, but they are not the most effective method for diagnosing gallstones. Some X-ray types may require the patient to swallow or have dye injected into the body to capture a clearer picture of the gallbladder.

CT Scans

CT scans use a computer and X-rays to identify gallbladder problems, but they are not the most effective method for diagnosing gallstones. However, they can help spot ruptures or infections within the gallbladder or bile ducts.

MRI and MRCP

Regular MRI scans, or a specialized type called magnetic resonance cholangiopancreatography (MRCP), can help diagnose stones in the bile ducts. MRCP uses regular MRI imaging technology plus a dye administered into the bile duct, making it very useful for diagnosing biliary tract (gallbladder and surrounding ducts) cancer, but it may not be able to spot tiny stones or persistent infections.

ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) is considered the “gold standard” for diagnosing stones blocking bile ducts. It uses an endoscope inserted through the throat, stomach, and into the small intestine to examine the bile ducts and sometimes remove any stones found during the procedure. However, this test carries a risk of complications, so it is typically only performed on patients who are thought to be very likely to have stones blocking the bile ducts.

Other Diagnostic Tests

In addition to imaging tests, doctors may also order blood and urine tests to help diagnose gallbladder problems. These can provide information about liver function, inflammation, and other potential issues.

The HIDA Scan

One specific diagnostic test for gallbladder problems is the cholescintigraphy, also known as a HIDA scan or gallbladder radionuclide scan. In this test, a small amount of radioactive dye is administered, and a scanning device is used to track the dye as it moves into the gallbladder. This can help identify a blocked duct or acute inflammation, but it may not be able to detect chronic gallbladder inflammation or gallstones.

Diagnosing gallbladder disease can involve a range of tests, from simple imaging scans to more invasive procedures. By understanding the various diagnostic options and when they are used, patients can work with their healthcare providers to identify and address any issues with this important organ.