Limitations of the cholecystogram.

There is a little doubt that the spontaneous passage of gallstones occurs sometimes without pain or jaundice. This is probably more frequent than is realised. While the cholecystogram is a reliable investigation and of great assistance to the clinician, occasionally a normal gallbladder will be demonstrated, when it has previously been the resting place of small gallstones. Four cases are described in which patients suffering clinically from cholelithiasis are shown to have a normal cholecystogram, but on repeat examinations gallstones are demonstrated in each case over intervals of one or two years. It is suggested that gallstones had been present in all these cases at the time of the initial symptoms, but could well have passed prior to the first examination.