technetium-tc-99m-lidofenin and Biliary-Atresia

Various problems are encountered in measuring gastric emptying, especially relating counts to the volume of meal remaining in the stomach. We have developed a method which has been validated against aspiration of the stomach. In gastric ulcer patients, however, the stomach is large and overlaps the bowel. Results of gastric emptying studies in patients who have had surgery for peptic ulceration show that impaired gastric emptying is related to the extent of vagotomy and pyloric surgery. We have examined the pattern of biliary excretion of iminodiacetic acid derivatives and related enterogastric reflux to the amount of bile in the stomach as determined by aspiration. However the reproducibility is only 75% probably due to day to day variation in its occurrence. The incidence of reflux in control subjects and in those with peptic ulcer is discussed, as is its relationship to the extent of vagotomy and the length of Roux-en-Y loops. Finally the diagnosis of biliary atresia using a similar radiopharmaceutical is described. It has been suggested that a high liver to heart ratio excludes the diagnosis of atresia, but we have failed to confirm this finding.

Topics: Bile Reflux; Biliary Atresia; Child; Digestive System; Digestive System Physiological Phenomena; Gastric Emptying; Humans; Imino Acids; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin

A 99mTc-HIDA scan was performed on a 4-mo-old female, six days after hepatic transplantation. Gradually, a diffuse increase in activity was seen over the peritoneal region, consistent with a slow bile leak into ascitic fluid. Although the scintigraphic appearance of a bile leak has been previously described, it is usually seen as a focal area of extrabiliary activity. In this case, we report a pattern identified when the leak occurs in conjunction with ascites.

Topics: Anastomosis, Surgical; Appendix; Ascites; Bile; Biliary Atresia; Common Bile Duct; Female; Humans; Imino Acids; Infant; Liver Transplantation; Organotechnetium Compounds; Radionuclide Imaging; Technetium Tc 99m Lidofenin

We present a case in which three congenital abnormalities, in separate organ systems, were identifiable on a 99Tcm HIDA scan. The patient probably had Ivemark syndrome with dextrocardia (confirmed by chest radiograph), horseshoe kidney (confirmed by 99Tcm DTPA scintigraphy), and biliary atresia (confirmed on the HIDA scan). He also probably had asplenia, as suggested by the HIDA scan, although this was not confirmed.

Topics: Abnormalities, Multiple; Biliary Atresia; Dextrocardia; Humans; Imino Acids; Infant; Kidney; Male; Organotechnetium Compounds; Pentetic Acid; Radionuclide Imaging; Spleen; Technetium Tc 99m Lidofenin; Technetium Tc 99m Pentetate

Topics: Bile Ducts; Biliary Atresia; Bilirubin; Diagnosis, Differential; Female; Humans; Imino Acids; Infant, Newborn; Jaundice, Neonatal; Male; Organometallic Compounds; Phenobarbital; Predictive Value of Tests; Radionuclide Imaging; Technetium Tc 99m Lidofenin