Rational combined X-ray examination of gallbladder and stomach

X-ray examination of patients with upper abdominal symptoms has been performed up to now mostly as a sequence of separate procedures; instead, an integrated procedure is recommended: a plain film of the upper abdomen should be taken first; a routine oral cholecystogram in the lying position 12 hrs after intake of the contrast medium should be omitted - instead the gallbladder should be visualized fluoroscopically with the patient remaining in the standing position or lying, and films should be taken during visualization. X-ray examination of the stomach and duodenum may follow immediately thereupon, eventually as well during pharmacologically induced hypotony. Then a fatty meal may be given in order to stimulate contraction of the gallbladder; if spasmolytics have been given before, contraction however might be hampered. The diagnostic significance of fatty meals applied as a routine procedure in X-ray diagnosis of gallbladder function is considered to be limited, on the other hand this procedure may improve the diagnosis of the morphological situation. (orig.)