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Liver, Biliary, and Pancreatic Disease: Diagnosis

How is a liver, biliary, or pancreatic disorder diagnosed?

In order to reach a diagnosis for liver, biliary, or pancreatic disorders, a thorough and accurate medical history will be taken by your physician, noting the symptoms you have experienced and any other pertinent information. A physical examination and a series of blood tests also are done to help assess the problem more completely.

The most commonly performed diagnostic procedures include the following:

  • computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure using a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  • magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  • ultrasound (Also called sonography.) - a diagnostic imaging technique, which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, spleen, and kidneys and to assess blood flow through various vessels. 
  • liver biopsy - a procedure in which small samples of the liver are removed (with a needle or during surgery) from the body for examination under a microscope. 
  • endoscopic retrograde cholangiopancreatography (ERCP) - a procedure that allows the physician to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines x-ray and the use of an endoscope - a long, flexible, lighted tube. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum. The physician can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected which will allow the internal organs to appear on an x-ray.
  • percutaneous transhepatic cholangiography (PTC) - a needle is introduced through the skin and into the liver where the dye (contrast) is deposited and the bile duct structures can be viewed by x-ray.
  • esophagogastroduodenoscopy (Also called EGD or upper endoscopy.) - a procedure that allows the physician to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the physician to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).
  • laparoscopy- use of a viewing tube with a lens or camera (and a light on the end), which is inserted through a small incision in the abdomen to examine the contents of the abdominal cavity and remove tissue samples.
  • cholecystography (Also called oral cholecystography or gallbladder series.) - a series of x-rays are taken of the gallbladder after a special contrast dye is swallowed, making it possible to detect gallstones, cholecystitis, and other abnormalities.
  • hepatobiliary scintigraphy - an imaging technique of the liver, bile ducts, gallbladder, and upper part of the small intestine.

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