Roentgenological observation in the disease of biliary tract by plain film study of abdomen

The author encountered 36 cases of the cholecystopathy confirmed by the operation or I.V. cholecystography after the plane films of abdomen were taken, and who were admitted through the emergency room at Busan National University and Busan Saint Benedict Hospitals from January 1977 to October 1978. Among them, the author analyzed especially 10 cases of the cholecystopathy showed the gallbladder shadow on the plain films of the abdomen and confirmed by the operation. After then, 104 cases of normal persons as a control group were taken the plain film study of the abdomen with the supine and erect positions. The findings obtained through this study were summarized as follows. 1. Among 36 cases of the cholecystopathy, the age distribution was 19 to 77 years of age, and the highest incidence was fifth decade. Sex ratio was equal in distribution.2. The most prominent symptom was right upper abdominal pain (97.2%). Then came radiating pain, fever, chilling, nausea, vomiting, and jaundice in that order. 3. The most common duration of the clinical onset was less 5 days. 4. The radiographic film of plain abdomen showed local meteorism in 91.7%, gallbladder shadow in 47.2%, and radiopaque gall stone, air in gallbladder and air in biliary duct in 2.7%, respectively. 5. In the control group, no gallbladder shadow and air in small intestine were seen on the radiographic films of plain abdomen, but some of the air shadow in hepatic and splenic flexures of colon were found in about 90.4% or more. 6. The diameters of the gallbladder shadow showed from 3.5 cm to 8,5 cm in width on the radiographic films of plain abdomen. The operative findings showed a severe inflammatory change in the wall of gallbladder, but no gall stone in the smaller cases of the gallbladder shadow. In the large cases, a single or multiple radiolucent stones in common bile duct or gall bladder, or tumor in common bile duct with inflammatory change in the call of gallbladder were found. 7. On the plain film, the gallbladder shadow was found only at the acute stage, for the reason that, in the two cases of the showing gallbladder shadow, the gall bladder shadow could not be shown on the plain film taken after remission of the clinical symptoms. 8. Consequently, the author concluded that the radiographic findings of showing gallbladder shadow and abnormal meteorism in plain films of abdomen could be considered as a key point to diagnose the cholecystography in patients of acute abdomen.