74290 Cholecystography, oral contrast

Name of the Procedure:

Cholecystography, Oral Contrast (Oral Cholecystogram, OCG)

Summary

Cholecystography, oral contrast, involves taking oral contrast medication followed by X-rays to examine the gallbladder. It helps visualize gallbladder function and identify potential issues such as gallstones or inflammation.

Purpose

This procedure addresses gallbladder problems such as gallstones, inflammation, or other abnormalities. The goal is to diagnose these conditions accurately, guiding further treatment.

Indications

• Symptoms like upper right abdominal pain, nausea, or vomiting suggesting gallstones
• Suspected gallbladder inflammation (cholecystitis)
• Jaundice indicating possible biliary tract issues

Preparation

• Fast for at least 8 hours before starting the procedure.
• Avoid fatty foods for 24 hours before taking the oral contrast.
• Inform your doctor of any allergies, especially to iodine or shellfish.
• Diagnostic liver function tests may be required beforehand.

Procedure Description

1. The patient ingests an oral contrast agent, usually iodine-based tablets.
2. The tablets are taken with water, often with meals, the day before the imaging.
3. After fasting, X-ray images are taken to visualize the gallbladder.
4. The X-rays are analyzed to identify any abnormalities such as stones or inflammation.
   • No anesthesia or sedation is required for this non-invasive procedure.
   • Equipment includes standard X-ray machinery and oral contrast tablets.

Duration

The procedure spans over two days – the first day for oral contrast ingestion and the second day for the X-ray imaging, which typically takes about 30-60 minutes.

Setting

The procedure is performed in a hospital or outpatient imaging center.

Personnel

• Radiologists oversee and interpret the X-rays.
• Radiologic technologists conduct the imaging process.

Risks and Complications

• Allergic reaction to the oral contrast agent (though rare).
• Mild side effects like stomach upset.
• Incomplete imaging if the gallbladder does not visualize well.

Benefits

• Non-invasive method to diagnose gallbladder issues.
• Helps in planning appropriate treatment.
• Immediate visualization typically within 24 hours after ingestion of the contrast agent.

Recovery

• Minimal to no recovery time needed.
• Resume normal diet and activities immediately after the procedure.
• Follow-up appointments if abnormalities are found.

Alternatives

• Ultrasound: Less invasive and no contrast needed, but less detailed.
• MRI/MRCP: More detailed imaging without ionizing radiation.
• Endoscopic Retrograde Cholangiopancreatography (ERCP): More invasive but allows for direct treatment of some conditions.

Patient Experience

• Ingestion of tablets might cause mild stomach discomfort.
• During X-ray imaging, patients need to stay still but the process is generally quick and painless.
• Pain management is typically unnecessary, and comfort measures include resuming normal activities and diet promptly.