The false-normal oral cholecystogram

Five case reports of patients at Akron City Hospital who underwent cholecystectomy following normal oral cholecystograms and who were found to have cholelithiasis or acalculous gallbladder disease are presented. In spite of the present day 90 to 95 percent accuracy of oral cholecystography, there may be occasional pharmocological and mechanical factors contributing to the nonvisualization of biliary calculi. However, the gallbladder which visualizes normally during cholecystography, on occasion, may contain nonvisualized biliary calculi or may be diseased in the acalculous state, resulting in the so-clled false-normal x-ray and presents several means by which the surgeon may prove or disprove biliary disease. We conclude the emphasis must be placed on surgical judgment when a patient presents with symptoms of cholelithiasis in the face of normal oral cholecystography.