(8) For an examination of the biliary ducts (by the intravenous injection of
Cholografin), the referring ward schedules and provides the preparation of the patient.
Usually, the patient does not eat anything after 1800 hours on the day prior to the
examination. On the morning of the examination, the patient is given a sensitivity test.
If the test is negative and there are no contraindications, 20 to 40 cc of the
cholecystopaque is injected intravenously by the radiologist. This examination is done
in the operating room using sterile techniques.
Cholecystography is a radiographic procedure for the demonstration of the
gallbladder after making the bile radiopaque by means of a contrast medium, which may
be administered either orally or intravenously.
a. Oral Method.
(1) The patient is prepared in accordance with the prescribed pre-
The contrast medium is administered according to prescribed
(3) Upon reporting to the x-ray department, the patient is dressed in a
suitable gown. He should be questioned as to how he carried out each step of the pre-
examination procedure and whether he experienced any vomiting or diarrhea. If any
vomiting or diarrhea occurred, the x-ray specialist should report it to the radiologist.
(4) The number and type of projections made depends upon prescribed
procedures and the suspected pathology. Usually, a survey film is made to determine
the position of the gallbladder, the correctness of the exposure factors, the presence
and extent of gas or unabsorbed contrast medium in the bowels, and evidence of
outstanding pathology. Details of the scout film are described below and illustrated in
figures 20 and 2-21.
Anatomical. General localization of the gallbladder.
Film. 14x17-inch film, and lengthwise. (Some radiologists prefer a
(c) Position. The patient is prone with arms alongside the body. He is
positioned as for a PA abdomen exposure with the crest of the ilium 3 inches below the
center of the film.
CR. The CR is aligned to the center of the film.
Precaution. Suspended expiration straight.