Presentation
Archived analog radiograph of a patient evaluated for suspected biliary pathology. X-ray obtained in the 1970s.
Patient Data
The cholecystographic contrast agent outlines the gallbladder revealing a filling defect with low density rim in its fundus, which represents a calculus. Note that the visible part of the liver is also showing increased opacification due to the contrast agent in the process of being excreted.
Case Discussion
Intravenous cholecystographic agents such as meglumine iodoxamate (Endobil) were commonly used before the widespread availability of B-mode US/CT to evaluate the gallbladder and the biliary tree. The contrast agent accumulated in the bile outlining the shape and size of the gallbladder, and could reveal stones as filling defects. By combining it with a fatty meal and sequential imaging it could be extended into a functional study of gallbladder emptying (note the dedicated radiopaque marker).
From the historical collection of the University of Pécs, Medical School, Radiology Clinic. Courtesy of the late Dr. Szilvia Boros.