Sequential hepatobiliary scintigraphy demonstrating apparent transient biliary obstruction.

Abstract

A case of acute acalculous cholecystitis in which sequential hepatobiliary scintigraphy demonstrated apparent transient biliary obstruction is presented. An initial technetium-99m diisopropyliminodiacetic acid ([99mTc]DISIDA) study in a patient suspected of acute cholecystitis showed persistent hepatic activity, nonvisualization of the gallbladder, and minimal intestinal activity seen only at 24 hr. Following a second injection of [99mTc]DISIDA administered shortly after the 24-hr image from the first study, the gallbladder and bowel were both visualized within 75 min. At subsequent surgery, acute and chronic cholecystitis were present without evidence of choledocholithiasis or other source of obstruction. Intrahepatic cholestasis following clearance of biliary obstruction may result in late bowel visualization on delayed cholescintigraphic images similar to that seen in partial obstruction. Accurate reflection of the state of hepatobiliary function may require reinjection with [99mTc]DISIDA.

• Authors: A F Jacobson, E B Cronin, B L Holman
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 28 Issue 11 Pg. 1775-9 (Nov 1987) ISSN: 0161-5505 [Print] United States
• PMID: 3668669 (Publication Type: Case Reports, Journal Article)

Chemical References

• Imino Acids
• Organometallic Compounds
• Technetium
• Technetium Tc 99m Disofenin

Topics

• Acute Disease
• Aged
• Cholecystitis (complications, diagnostic imaging)
• Cholestasis (diagnostic imaging, etiology)
• Humans
• Imino Acids
• Male
• Organometallic Compounds
• Radionuclide Imaging
• Technetium
• Technetium Tc 99m Disofenin
• Time Factors