How is it Diagnosed?
Gallstones are hardened deposits, usually made of cholesterol or bilirubin, that form in
the gallbladder. Diagnosis begins with a thorough history, focusing on classic symptoms
such as right upper abdominal pain, especially after fatty meals, nausea, vomiting, and
sometimes jaundice if the bile duct is obstructed.
Physical examination may reveal tenderness in the right upper quadrant. A positive
Murphy’s sign, where pain increases during inhalation when palpating under the right
rib cage, can suggest gallbladder inflammation (cholecystitis) due to gallstones.
The most effective diagnostic tool is abdominal ultrasound, which can detect gallstones
with high sensitivity and is the first-line imaging modality. It can also assess gallbladder
wall thickening, bile duct dilation, and pericholecystic fluid.
In certain cases, further imaging such as CT scan or MRI (MRCP – Magnetic Resonance
Cholangiopancreatography) is used for better visualization of the biliary tree, especially
when complications like choledocholithiasis or pancreatitis are suspected.
Endoscopic Ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography
(ERCP) may also be used when common bile duct stones are suspected. ERCP can
serve both diagnostic and therapeutic roles by visualizing and removing the stones.
Blood tests may reveal elevated liver enzymes, bilirubin, or white blood cell count in
cases of infection or ductal obstruction.
Together, clinical evaluation, imaging, and lab results form a comprehensive approach to
diagnosing gallstones and determining the appropriate intervention.