technetium-tc-99m-lidofenin and Acute-Disease

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Topics: Abdomen, Acute; Acute Disease; Cholecystitis; Female; Humans; Imino Acids; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Lidofenin; Ultrasonography

Acute cholecystitis is a relatively common clinical entity characterized histopathologically by obstruction of the cystic duct due to either edema or stone or both. Thorough clinical assessment and selection of the appropriate diagnostic tests are crucial in making an early diagnosis before surgical treatment. Many diagnostic tests are available for imaging the gallbladder. Hepatobiliary imaging using technetium Tc 99m IDA is the test of choice to either exclude or confirm the diagnosis of acute cholecystitis and it carries a discriminating power greater than that of cholecystography or ultrasonography. In most patients the exclusion of the diagnosis of acute cholecystitis can be made as early as 30 minutes and the confirmation within three hours. The confirmation of acute cholecystitis by radionuclide imaging obviates the need for either cholecystography or ultrasonography.

Topics: Acute Disease; Cholecystectomy; Cholecystitis; Cholecystography; Cholelithiasis; Costs and Cost Analysis; Diagnosis, Differential; Evaluation Studies as Topic; Gallbladder; Humans; Imino Acids; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Topics: Acute Disease; Adult; Bile Duct Diseases; Bile Ducts; Child; Cholecystitis; Cholecystokinin; Cholestasis, Extrahepatic; Cystic Duct; Humans; Imino Acids; Iodine Radioisotopes; Radionuclide Imaging; Rose Bengal; Technetium; Technetium Tc 99m Lidofenin

Patients with the clinical diagnosis of acute cholecystitis were studied with intravenous cholecystography and cholescintigraphy. The two examinations alternated in a random order. The final diagnosis was ascertained by surgery in most patients. Either cholecystography or cholescintigraphy could be used in the diagnostics of patients with suspected acute cholecystitis. The methods have about the same accuracy. However, cholescintigraphy is performed more easily and more rapidly than intravenous cholecystography.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Cholecystitis; Contrast Media; Female; Humans; Imino Acids; Infusions, Intravenous; Ioglycamic Acid; Male; Middle Aged; Organotechnetium Compounds; Radiography; Radionuclide Imaging; Technetium Tc 99m Lidofenin

Topics: Abdominal Pain; Acute Disease; Adult; Cholecystitis; Female; Humans; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Lidofenin

This study was designed to retrospectively determine recent clinical trends of initial radiological evaluation in patients pathologically proven to have acute cholecystitis (AC) and to assess the methodology that led to its diagnosis. Over a 28-month period, the medical records and imaging studies of 117 consecutive patients who had pathologically confirmed AC were retrospectively analyzed. The sensitivities of ultrasound (US) and hepatobiliary 99mTc-iminodiacetic acid (HIDA) were computed. The false-negative scans were retrospectively reviewed by a blinded radiologist to determine the limitations and advantages of each modality. The 117 patients were grouped into six categories based on the type of imaging examination they underwent prior to cholecystectomy: initial US evaluation only (n=80, 68.4%), initial US followed by HIDA (n=17, 14.5%), initial HIDA only (n=2, 1.7%), initial HIDA followed by US (n=3, 2.6%), initial CT (n=5, 4.3%), and no imaging evaluation (n=10, 8.6%). HIDA scan had a calculated sensitivity of 90.9% (20 true-positive, 2 false-negative) while US had a sensitivity of 62% (62 true-positive, 38 false-negative). Current practice in the initial radiological evaluation of acute cholecystitis remains outdated. The vast majority of patients in our study group were initially worked up using US, although HIDA scan has been shown to have greater sensitivity for the diagnosis of acute cholecystitis.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Child; Cholecystitis; Female; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Lidofenin; Ultrasonography

AIDS patients are susceptible to opportunistic gastrointestinal infections including ascending cholangitis and cholecystitis, especially if CD4 count is < 200. Incidence of acalculous cholecystitis has not been reported previously.. We aim to evaluate the incidence of acalculous cholecystitis in AIDS patients and to identify causative organisms and mortality rate following cholecystectomy.. We reviewed the files of 46 patients in order to meet the objectives of this study.. CD4 counts were < 200 in 31 patients and > 200 in 15 patients. HIDA imaging was performed in 31 patients; in 8, the CD4 count was > 200 and all had calculous cholecystitis. The gallbladder was visualized in 3 patients for a sensitivity of 63% and no organisms were found in the gallbladder specimens. In 23 patients, the CD4 count was < 200; the gallbladder was visualized in 5 patients for a HIDA sensitivity of 78%; 16 (52%) had acalculous cholecystitis; and 15 had calculous cholecystitis. In acalculous cholecystitis, Cryptosporidium was found in six cases, cytomegalovirus (CMV) in six cases, and fungus, yeast, tuberculosis, and mycobacterium avium intracellular each in one case. The thirty day mortality rate was 18%; 5 of 28 who underwent open cholecystectomy died within 30 days, 4 of them with a CD4 count < 200. There was no mortality in the 26 patients who underwent laparoscopic cholecystectomy.. (1) Because of the high incidence of 52% of acalculous cholecystitis in AIDS patients with a CD4 count < 200, we recommend using intravenous cholecystokinin if the gallbladder is visualized on hepatobiliary scintigraphy in order to determine gallbladder ejection fraction and exclude acalculous cholecystitis. (2) Laparoscopic rather than open cholecystectomy should be the surgical procedure of choice in AIDS patients especially if the CD4 count is < 200.

Topics: Acquired Immunodeficiency Syndrome; Acute Disease; AIDS-Related Opportunistic Infections; CD4 Lymphocyte Count; Cholecystectomy; Cholecystitis; Cholelithiasis; Gallbladder; Humans; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Lidofenin

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Gangrene; Humans; Imino Acids; Liver; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Lidofenin; Ultrasonography

Pharmacological intervention with either cholecystokinin-8 (CCK-8) or morphine during 99mTc- hepatoiminodiacetic acid (HIDA) cholescintigraphy is required primarily for the assessment of the diseases affecting the gallbladder, the common bile duct, or the sphincter of Oddi. For imaging, the patient should be prepared by an overnight fast, or with 4 hours of minimum fast. Pre-emptying with CCK-8 is probably undesirable and should either be avoided or one should wait for at least 4 hours after CCK-8 to begin the 99mTc-HIDA study to achieve higher specificity of the test for acute cholecystitis. When he gallbladder is not observed by 60 mins in a clinical setting of acute cholecystitis, a dose of 0.04 mg/kg of morphine is administered intravenously and imaging continued for an additional 30 mins. Nonvisualization of the gallbladder by 90 mins with morphine in an appropriate clinical setting is diagnostic for acute cholecystitis. When the gallbladder is not observed by 60 min but is seen with morphine administered after 60 mins, a positive diagnosis of abnormal gallbladder function can be made. When the gallbladder is observed in a clinical setting of biliary pain or chronic calculous or acalculous cholecystitis, CCK-8 at a dose rate of 3.3 ng/kg/min is infused intravenously for 3 mins (10 ng/kg/3 min) for the measurement of the ejection fraction. An ejection fraction value of less than 35% is indicative of calculous or acalculous chronic cholecystitis. The gallbladder emptying is directly related to the total number of cholecystokinin receptors in the smooth muscle. The ejection fraction can be controlled to any desired level simply by controlling the dose rate or the duration of infusion of CCK-8. Morphine and other opiate metabolites circulate for many hours in blood and act on the sphincter of Oddi and decrease the gallbladder ejection fraction. Careful drug history, especially that of opiates, is very critical in all subjects with a low ejection fraction before assigning an abnormality to the gallbladder motor function.

Topics: Acute Disease; Bile; Biliary Tract; Cholecystitis; Cholecystokinin; Gallbladder Emptying; Humans; Imino Acids; Morphine; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin

Cholescintigraphy with morphine augmentation is used routinely to expedite the differential diagnosis of acute from chronic cholecystitis. A patient with hepatic dysfunction and an allergy to morphine received intravenous meperidine in conjunction with cholescintigraphy. The gallbladder was not visualized 30 minutes after administration of the drug. However, the activity accumulated in the initial photon deficient gallbladder at 4 hours after meperidine administration (6.5 hours after radiopharmaceutical administration). These findings may be explained in part by prolongation of meperidine bioavailability because of impairment of hepatic function.

Topics: Acute Disease; Cholecystitis; Chronic Disease; Diagnosis, Differential; Drug Hypersensitivity; Gallbladder; Humans; Imino Acids; Male; Meperidine; Middle Aged; Morphine; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin; Time Factors

Topics: Acute Disease; Cholecystitis; Gallbladder; Humans; Imino Acids; Organotechnetium Compounds; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Lidofenin

We studied emergency hepatobiliary scintigraphy in the 43 patients to rule out acute cholecystitis. After injection of 185-222 MBq (5-6 mCi) of 99mTc-EHIDA or 99mTc-HIDA, serial static scintigraphic images were obtained up to 7 hours in maximum. Of 43 patients in this study, 20 had a normal scan and finally in all of them cholecystitis was ruled out. Of the 43 patients, 14 had an abnormal scan (nonvisualized gall bladder). In 10 of them the diagnosis of acute cholecystitis was confirmed after emergency cholecystectomy. The other 9 patients of 43 had an incomplete scan mainly due to liver dysfunction. Four of them had acute cholecystitis in the cholecystectomy. These results indicate that acute cholecystitis can be excluded by the findings of gall bladder visualization in hepatobiliary scintigram. We concluded that emergency hepatobiliary scintigraphy is very useful to rule out acute cholecystitis.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Biliary Tract; Cholecystitis; Emergencies; Female; Gallbladder; Humans; Imino Acids; Liver; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Diethyl-iminodiacetic Acid; Technetium Tc 99m Lidofenin

Topics: Acute Disease; Aged; Cholecystectomy; Cholecystitis; Confusion; Diagnosis, Differential; Humans; Hypothermia; Imino Acids; Male; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin; Thrombocytopenia; Ultrasonography

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Cholangiography; Cholecystitis; Female; Humans; Imino Acids; Male; Middle Aged; Organometallic Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin; Ultrasonography

Fifty-four patients with suspected acute cholecystitis underwent 99mTc HIDA cholescintigraphy, ultrasonography and oral cholecystography. The correct diagnosis was reached in 49 patients by cholescintigraphy (91%) in 35 (65%) by ultrasonography and in 45 (83%) by oral cholecystography. 99mTc HIDA cholescintigraphy provides a rapid accurate diagnosis with minimal discomfort to the patient and is the investigation of choice for patients with symptoms of acute gallbladder disease, particularly if early cholecystectomy is to be considered.

Topics: Acute Disease; Cholecystitis; Cholecystography; Cholelithiasis; False Positive Reactions; Gallbladder Diseases; Humans; Imino Acids; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

The benefit of early surgery for patients with acute cholecystitis is now accepted but rapid accurate pre-operative diagnosis is important and the single best investigation has not yet been clearly established. All 47 patients with suspected acute cholecystitis admitted to a district general hospital during a 6 month period underwent ultrasonic examination and scintigraphy with HIDA within 48 h of admission. In 23 patients acute cholecystitis was proven. Ultrasound correctly diagnosed this in 21 patients but in 2, changes attributed to chronic cholecystitis only were detected. Two false positive ultrasound results also occurred, one in a patient with adenomyomatosis and acute pancreatitis, the other in a case of duodenitis. HIDA scan was diagnostic in 19 patients but in the remaining 4 the presence of abnormal liver function tests accounted for non-visualization of the biliary tree (a non-diagnostic result). In the absence of jaundice a HIDA scan is the more specific test for confirming acute cholecystitis.

Topics: Acute Disease; Cholecystectomy; Cholecystitis; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Time Factors; Ultrasonography

Two patients presenting with right upper abdominal colicky pain, jaundice, and fever had a hepatobiliary scan using Tc 99m HIDA. The scan was suggestive of acute cholecystitis and a space occupying lesion in the liver. On operation, liver echinococcosis, located in the right lobe rupturing into the biliary ductal system, was found. Intraoperative cholangiography revealed filling defects in the main biliary ducts. Exploration of the common bile duct disclosed daughter cysts and cystic debris. Acute cholecystitis or stones were not found. We conclude that in patients with a clinical picture and HIDA scanning compatible with acute cholecystitis and a space occupying lesion in the liver, the diagnosis of hydatid cyst of the liver which has ruptured into the biliary tract should be considered.

Topics: Acute Disease; Aged; Bile Duct Diseases; Bile Ducts; Cholecystitis; Diagnosis, Differential; Echinococcosis, Hepatic; Humans; Imino Acids; Liver; Male; Middle Aged; Radionuclide Imaging; Rupture, Spontaneous; Technetium; Technetium Tc 99m Lidofenin

The value of infusion cholecystography 99mTc HIDA cholescintigraphy and ultrasonography was compared in 51 patients presenting with a clinical diagnosis of acute cholecystitis. Of the 35 patients with proven gallbladder disease, the presence of gallstones was correctly predicted in 31 (88 per cent) by infusion cholecystography, 32 (90 per cent) by 99mTc HIDA cholescintigraphy and 27 (77 per cent) by ultrasonography. There were no false positive investigations. Infusion cholecystography may be of particular interest to surgeons with no ready access to isotope scanning techniques.

Topics: Acute Disease; Cholecystitis; Cholecystography; Cholelithiasis; Contrast Media; Gallbladder Diseases; Humans; Imino Acids; Iodobenzoates; Ioglycamic Acid; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Topics: Acute Disease; Bayes Theorem; Cholecystitis; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Technetium-99m iminodiacetic acid (IDA) cholescintigraphy was performed in 15 patients with acute acalculous cholecystitis. Fourteen of the 15 patients with acute disease had positive findings, indicating the presence of cystic duct or common duct obstruction. One case in which the gallbladder was visualized failed to respond to sincalide stimulation; this was classified as a suggestive finding of disease. The diagnostic accuracy of 99mTc-IDA cholescintigraphy was far superior to the other imaging studies used (8 sonograms, 1 intravenous cholangiogram, 3 oral cholecystograms, 1 percutaneous transhepatic cholangiogram). The 99mTc-IDA study is recommended as the imaging procedure of choice for examining patients with suspected acute acalculous cholecystitis.

Topics: Acute Disease; Aged; Cholecystitis; Cholelithiasis; Cholestasis; Female; Gallbladder; Humans; Imino Acids; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Lidofenin

Topics: Acute Disease; Adult; Aged; Cholecystitis; Female; Gallbladder; Humans; Imino Acids; Liver; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

The recent availability of iminodiacetic acid analogues labeled with technetium Tc 99m provides a safe and accurate noninvasive test of biliary function. Biliary scintigraphy is a simple and rapid method of detecting acute cholecystitis in particular but also of distinguishing acute biliary pancreatitis from nonbiliary pancreatitis, of evaluating the patency of the common duct in early obstruction, of assessing possible postcholecystectomy syndrome, of evaluating the patency of a biliary enteric bypass, and of detecting postoperative biliary leaks.

Topics: Acute Disease; Biliary Tract; Biliary Tract Diseases; Biliary Tract Surgical Procedures; Cholecystitis; Cholelithiasis; Cholestasis; Humans; Imino Acids; Methods; Postoperative Complications; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

In five of seven patients with acute pancreatitis, Tc-99m HIDA scintigraphy failed to visualize the gallbladder. In all five patients the gallbladder was later found to be normal and in three of them normal filling was obtained at a repeat examination performed after the attack had subsided. Transient nonvisualization of the gallbladder in acute pancreatitis is probably due to disturbed motility of the biliary tree.

Topics: Acute Disease; Adult; Biliary Tract; Cholecystitis; Diagnosis, Differential; Gallbladder; Humans; Imino Acids; Male; Pancreatitis; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Time Factors

Radionuclide hepatobiliary imaging (HIDA scanning), a pathophysiologic modality, has become the diagnostic method of choice for suspected acute cholecystitis. The diagnosis is made quickly with this technic, which is simple, safe, and accurate. It is in widespread use and will soon be available for small community hospitals as well as large metropolitan and university centers. Ultrasound, though an excellent anatomic modality for diagnosing cholelithiasis, does not demonstrate the status of the cystic duct, information essential to the diagnosis of acute cholecystitis.

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Cystic Duct; Evaluation Studies as Topic; Gallbladder; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Topics: Acute Disease; Cholecystitis; Diagnosis, Differential; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Topics: Acute Disease; Adolescent; Adult; Aged; Cholecystitis; Diagnosis, Differential; Female; Gallbladder; Humans; Imino Acids; Male; Middle Aged; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Cholescintigraphy with 99m-Tc labeled iminodiacetic acid (IDA) derivatives has proved to be extremely reliable in the evaluation of suspected acute cholecystitis. The major diagnostic feature of the study is the presence (cystic duct patency) or absence (cystic duct obstruction) of gallbladder visualization. Secondary findings include degree and rate of liver uptake, visualization and caliber of the intrahepatic and common bile ducts, and the presence of intestinal activity as well as rapidity of biliary tract-to-bowel transit of the radiotracer. Various combinations of these secondary parameters result in a spectrum of cholescintigraphic patterns which can assist in determining the cause of the patient's acute clinical problem.

Topics: Acute Disease; Cholecystitis; Humans; Imino Acids; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Lidofenin

Topics: Acute Disease; Aged; Cholecystitis; Cholecystography; Cholelithiasis; Gallbladder Diseases; Humans; Imino Acids; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Gallbladder; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

Changes in the radiological diagnosis of gallbladder disease are occurring at a remarkable rate. In this symposium, several recognized authorities place the various diagnostic modalities and their interrelation in modern perspective. The present and future roles of oral cholecystography and intravenous cholangiography, the radiological diagnosis of chronic acalculous cholecystitis, and the use of ultrasonography and cholescintigraphy are analyzed.

Topics: Acute Disease; Cholangiography; Cholecystitis; Cholecystography; Cholecystokinin; Chronic Disease; Gallbladder Diseases; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Diethyl-iminodiacetic Acid; Technetium Tc 99m Lidofenin; Tomography, X-Ray Computed; Ultrasonography

Topics: Acute Disease; Biliary Tract; Cholecystitis; Cholecystography; Cholelithiasis; Humans; Imino Acids; Liver Function Tests; Pancreatitis; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

A prospective comparative study was made of 99mTc-HIDA cholescintigraphy and 24-h infusion cholecystography for the diagnosis of acute cholecystitis. The material comprised 50 patients. Non-visualization of the gallbladder was regarded as a positive result and as indicative of acute cholecystitis. The final diagnoses were made at operation (36 patients), by additional examinations (9 patients), by a typical clinical course (3 patients), and at autopsy (2 patients). The predictive value of a positive and a negative cholescintigraphy was 92.6% and 95.7%, respectively. The predictive value of a positive and a negative infusion cholecystography was 78.6% and 81.8%, respectively. There was no statistically significant difference between the results of the two tests. The 99mTc-HIDA cholescintigraphy was easier and quicker to perform than the cholecystography, and likewise the scintigrams were easier to assess than the infusion cholecystograms. The diagnostic certainty of cholescintigraphy was found to be high, and the test is recommended in patients suspected of having acute cholecystitis.

Topics: Acute Disease; Adult; Aged; Cholecystitis; Cholecystography; Female; Humans; Imino Acids; Male; Middle Aged; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Technetium-99m dimethyl iminodiacetic acid cholescintigraphy has contributed significantly to the diagnosis of acute and chronic biliary tract disorders. Yet attention should also be focused on the other structures visualized during the blood pool, hepatocyte, renal excretory, and intestinal phases of the study. Nonbiliary pathology was detected in 42 of 294 patients (14.3%) studied for suspected acute cholecystitis. The serendipitous detection of previously unsuspected abnormalities assisted in directing further work-up from suspected biliary disease and towards the real source of the patient's acute problem in 28 cases (9.5%).

Topics: Acute Disease; Adult; Appendicitis; Cholecystitis; Diagnosis, Differential; Heart; Heart Diseases; Humans; Imino Acids; Intestinal Diseases; Intestines; Kidney; Kidney Diseases; Liver; Liver Diseases; Perfusion; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

A newer approach to the early diagnosis of acute biliary tract disease is review. Ninety-two patients were evaluated with a new hepatobiliary agent (H.I.D.A/P.I.P.D.A.) for the presence of cystic duct obstruction. Seven patients with suspected acute gall bladder disease were dropped from the study for the lack of pathologic confirmation of the diagnosis. Forty-four of the remaining 85 patients were subsequently operated on and found to have acute cholecystitis. Forty-three of the 44 had cystic duct obstruction demonstrated on H.I.D.A. Scan (one false negative). An additional 23 patients underwent cholecystectomy for chronic disease. In this group, the gallbladder scan was only 43% (10/23) accurate in correctly identifying disease. Eighteen patients with nonbiliary disease had normal scans. The accuracy of ultrasonography and the scan are also compared in a smaller subgroup of 53 patients who had both studies.

Topics: Acute Disease; Adolescent; Adult; Aged; Cholecystitis; Cholestasis, Extrahepatic; Cystic Duct; Female; Humans; Imino Acids; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography

A series of 105 patients with upper abdominal pain suggestive of biliary colic who had hepatobiliary scans within 48 h of admission to hospital is presented. Fifty of the 65 patients with abnormal scans had operative treatment and gallbladder pathology was found in every case. Fourteen of these patients had hepatobiliary scans which also showed delayed excretion of tracer into the duodenum, and of these, 12 were found to have common bile duct stones and one a stricture of the distal end of the common bile duct. Of the 40 patients who had normal scans, 7 were found to have gallstones on further investigation. In these patients abnormal hepatobiliary scans have shown a 100 per cent correlation with gallbladder disease. We suggest that this is the investigation of choice for the surgeon contemplating early cholecystectomy on patients with suspected acute gallbladder disease.

Topics: Acute Disease; Adult; Biliary Tract; Gallbladder Diseases; Humans; Imino Acids; Liver; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Time Factors