OCG (Oral cholecystogram) BY Akash Das

This PPT is all about Oral cholecystogram.
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Akash Das BMRIT 2nd Year

1. By, Akash Das Student Code- BWU/BRI/19/005 Paper Code- BMRIT-305 Oral Cholecystography ( OCG )

2. INTRODUCTION Definition : Oral Cholecystography or Oral Cholecystogram is the radiographic study of gallbladder by the oral administration contrast media. Oral Cholecystography ( OCG ) It was developed in 1924 by American surgeons E.A Graham & W. H Cole. But now days it is largely superseded by ultrasound and  MRCP . This is the initial examination for the investigation of biliary tract. Fig- 1: Gallbladder

3. Indication Inflammation of the organ. Other abnormalities like polyps. Tumors Gallstones To visualizing cystic duct and common bile. To demonstrate suspected pathology in the gallbladder. Fig- 3 : Gallstone Formation Fig- 2 : Polyp Inside Gallbladder

4. C ontraindication Pr severe hepatorenal disease. Acute cholecysititis Iodine sensitivity Pregnancy Dehydration An IV cholecystography within the previous week evious cholecystectomy. Fig- 4 : Acute Cholecysititis Fig- 5 : Pregnancy

5. Patient Preparation Patient should take low residue diet for 2 days prior to examination . A laxative 2 days prior to the examination. The CM is taken with water 14 hours prior to the examination. A fat-containing meal after preliminary film, if the gallbladder is not visualize by contrast media. Food is forbidden until the examination is completed. Fig-6 : Gall Stone Formation Fig-7 : Radiographic Appearance of GB

6. Contrast Media 1. Biloptin 2. Telepaque 3. Cholebrin 4. Solu-Biloptin Films Prone 20º LAO Supine 20º RPO Erect 20º LAO Fatty meal provided. Prone 20º LAO 30 minutes after a fatty meal. Fig- 9 : Positioning of patient for OCG Fig- 8 : Biloptin Capsules

7. Procedure A night before the examination 6 tablet of Teleopaque or Biloptin is given orally. After 12-16 hours a prone oblique view with right side raised to 20º is taken for gallbladder visualization. After the preliminary film taken, the patient lie in the supine p osition and appropriate spot film of the gallbladder are taken. Ask the patient to eat fatty meal. After 30-40 min. films are taken to assess the contractibility of the gallbladder and small filling defect. (stones or polpyps) Cystic and common bile duct also visualized in post fatty meal films. * If the GB not visualized a "double dose" OCG may have to be performed where the patient takes in all 12 tablets of CM.

8. Complication Mild gastrointestinal disturbances Skin reactions Uricosuric action Impaired renal function Psedoalbuminuria Abnormal thyroid function tests Increased effect of protein-bound drugs because of shared binding with albumen Fig- 11: Gastrointestinal Disturbances Fig- 10: Skin Reactions

9. Radiation Protection There are many ways by which we can protect our self from scattered radiation, like- By using Protective apron:0.5mmPb L ead shield:0.5mm Pb Lead protective gloves. Film badge or TLD monitor. And also we should always the rule of TDS & ALARA principle We can also use b eam limiting devices like cone to minimize the radiation dose. Fig- 14: Beam Limiting Device (Cone) Fig- 13: Cardinal’s principle (TDS) Fig- 12: Lead apron, shield, gloves & TLD

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