[Biliary colic: imaging diagnosis]

J Radiol. 2006 Apr;87(4 Pt 2):413-29. doi: 10.1016/s0221-0363(06)74024-0.
[Article in French]

Abstract

Biliary colic is the most common clinical presentation of symptomatic gallstone disease, whatever its localisation (cholelithiasis or choledocolithiasis). The pain of biliary colic is unfortunately called "colic", a word suggesting paroxystic bouts and usually described as localised in the right upper quadrant. In fact, biliary pain is most frequently epigastric in location, usually starts abruptly to generally persists without fluctuation and resolve gradually over two to four hours. Biliary lithiasis has a high prevalence in the population, especially in elderly women but only 20% of the patients are symptomatic and among them, only 10 to 20% experience severe pain. Misdiagnosis is frequent with potential disastrous implications, especially with other causes of epigastric pain (atypical myocardial ischemia, perforated ulcer, etc.). Non invasive imaging of the biliary tract is now generally easy to obtain; abdominal ultrasound for gallbladder stones and magnetic resonance cholangiography for the main bile duct and the intrahepatic bile ducts. But, for gallbladder stones, the greatest care must be taken by the radiologist to link up the symptomatology and the cholelithiasis. Precise description of the abdominal pain (nature, intensity, location, duration, irradiation...) is needed and must be searched by the radiologist to prevent misdiagnosis.

Publication types

  • Case Reports
  • Comparative Study
  • Historical Article
  • Review

MeSH terms

  • Adult
  • Bile Ducts, Intrahepatic
  • Biliary Tract Diseases / diagnosis*
  • Biliary Tract Diseases / diagnostic imaging
  • Cholangiopancreatography, Magnetic Resonance
  • Cholangitis / diagnosis
  • Cholangitis / diagnostic imaging
  • Cholecystitis, Acute / diagnosis
  • Cholecystitis, Acute / diagnostic imaging
  • Cholecystolithiasis / diagnosis
  • Cholecystolithiasis / diagnostic imaging
  • Choledocholithiasis / diagnosis
  • Choledocholithiasis / diagnostic imaging
  • Cholelithiasis / chemically induced
  • Cholelithiasis / diagnosis
  • Cholelithiasis / diagnostic imaging
  • Colic / diagnosis*
  • Colic / diagnostic imaging
  • Colic / physiopathology
  • Diagnosis, Differential
  • Diagnostic Errors
  • Female
  • History, 18th Century
  • Humans
  • Male
  • Radionuclide Imaging
  • Risk Factors
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed
  • Ultrasonography