Segmental ultrasonic test for the study of cholecystodyskinesia

Ten patients of ages 35 to 61 years with 'cholecystopathy' received an injection of 20 ml, 40% biligrafin. X-rays of the gall-bladder area were taken before and at certain intervals after the injection. This was followed by ultrasonic stimulation (applied using the impulse technique) for ten to twenty minutes at frequencies of 3 MHz, effective intensity of 1.4-2.8 W cm-2 and with paraffin oil as a contact agent. The dorsal segments were subjected to ultrasonic stimulation of weaker intensity but longer duration than the ventral segment. The gall-bladder shadow was analysed planimetrically, and an approximate volumetric calculation was attempted. The results show that the gall-bladder responds to segmental ultrasonic stimulation by both contraction and dilatation, presumably through a cutaneous visceral reflex arch, a qualitatively and quantitatively different response to that of egg yolk. Segmental ultrasonic stimulation of the gall-bladder seems to be a suitable complement to fatty meal treatment, particularly where this 'contra-indicated'. In addition it offers the possibility of differentiating between hyper and hypokinetic forms of gall-bladder dyskinesia. Finally, it was observed that a more marked effect on the gall-bladder can be produced by dorsal-segmental stimulation than by stimulation over the ventral points.