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ARTICLE |

Cholecystography With lopanoic Acid "Reinforcement" Before Initial Study FREE

Paul Mandelstam, MD; Harold D. Rosenbaum, MD
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JAMA. 1975;232(6):642-642. doi:10.1001/jama.1975.03250060038021
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An estimated 15 million Americans are afflicted with gallstones;1 the differential diagnosis of biliary tract disease is one of the major problems of adult clinical medicine. Oral cholecystography has long been the mainstay of roentgen evaluation, and iopanoic acid (Telepaque) has for many years been the agent most frequently used for this examination. More than 20 years of extensive clinical use has established the safety of this agent; administration of very large doses in the presence of severe hepatorenal disease appears to be the only specific contraindication.

Since the initial report in 1959,2 a number of studies have confirmed that gallbladder opacification sufficient for diagnosis is not obtained in 20% to 30% of patients administered iopanoic acid in the usual initial dose of 3 gm. When the initial dose results in total nonopacification of the gallbladder, reinforcement with a second dose of 3 gm results in a normal

REFERENCES

Ingelfinger FJ:  Digestive disease as a national problem: V. Gallstones . Gastroenterology 55:102-104, 1968;.
Rosenbaum HD:  The value of re-examination in patients with inadequate visualization of the gallbladder following a single dose of Telepaque . Am J Roentgenol Radium Ther Nucl Med 82:1011-1015, 1959;.
Berk RN:  The consecutive dose phenomenon in oral cholecystography . Am J Roentgenol Radium Ther Nucl Med 110:230-234, 1970;.
Berk RN:  The problem of impaired first-dose visualization of the gallbladder . Am J Roentgenol Radium Ther Nucl Med 113:186-188, 1971;.
Berk RN, Loeber PN, Goldberger LE, et al:  Oral cholecystography with iopanoic acid . N Engl J Med 290:204-210, 1974;.
Mujahed Z, Evans JA, Whalen JP:  The nonopacified gallbladder on oral cholecystography . Radiology 112:1-4, 1974;.
Whalen JP, Rizzuti RJ, Evans JA:  Time of optimal gallbladder opacification with Telepaque (iopanoic acid) . Radiology 105:523-524, 1972;.

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Ingelfinger FJ:  Digestive disease as a national problem: V. Gallstones . Gastroenterology 55:102-104, 1968;.
Rosenbaum HD:  The value of re-examination in patients with inadequate visualization of the gallbladder following a single dose of Telepaque . Am J Roentgenol Radium Ther Nucl Med 82:1011-1015, 1959;.
Berk RN:  The consecutive dose phenomenon in oral cholecystography . Am J Roentgenol Radium Ther Nucl Med 110:230-234, 1970;.
Berk RN:  The problem of impaired first-dose visualization of the gallbladder . Am J Roentgenol Radium Ther Nucl Med 113:186-188, 1971;.
Berk RN, Loeber PN, Goldberger LE, et al:  Oral cholecystography with iopanoic acid . N Engl J Med 290:204-210, 1974;.
Mujahed Z, Evans JA, Whalen JP:  The nonopacified gallbladder on oral cholecystography . Radiology 112:1-4, 1974;.
Whalen JP, Rizzuti RJ, Evans JA:  Time of optimal gallbladder opacification with Telepaque (iopanoic acid) . Radiology 105:523-524, 1972;.
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