technetium-tc-99m-lidofenin and Pancreatitis

Biliary microlithiasis is an uncommon but recognized cause of upper abdominal pain, cholecystitis, cholangitis, and pancreatitis in adults. Gallstones smaller than 3 mm may not be seen on transabdominal ultrasound and may only be seen on endoscopic ultrasound. This condition is poorly described in children. The aim of this study is to review the results of laparoscopic cholecystectomy to treat biliary microlithiasis in a pediatric case series.. We performed a retrospective case review of children with biliary microlithiasis who were treated with laparoscopic cholecystectomy.. Three children were diagnosed with biliary microlithiasis. Two patients had recurrent right upper quadrant pain and nausea. A third patient had midepigastric pain and idiopathic pancreatitis. All 3 had a normal gallbladder on transabdominal ultrasound. Additional imaging with hepatobiliary scan, computed tomography, and magnetic resonance cholangiopancreatography revealed no biliary source for symptoms. Endoscopic ultrasound was performed on all 3 children, demonstrating microlithiasis of the gallbladder. Each child had a laparoscopic cholecystectomy with intraoperative cholangiogram. No abnormalities were seen on intraoperative cholangiogram. All 3 children had alleviation of pain and improvement of symptoms in postoperative follow-up.. Children with biliary microlithiasis and associated clinical symptoms can be successfully treated with laparoscopic cholecystectomy. Endoscopic ultrasound should be considered in the evaluation of the child with clinical biliary symptoms and a negative transabdominal ultrasound result.

Topics: Adolescent; Age of Onset; Antibiotic Prophylaxis; Ceftriaxone; Child; Cholagogues and Choleretics; Cholangiography; Cholangiopancreatography, Magnetic Resonance; Cholecystectomy, Laparoscopic; Cholelithiasis; Combined Modality Therapy; Comorbidity; Endosonography; False Negative Reactions; Female; Follow-Up Studies; Humans; Male; Neurosurgical Procedures; Pancreatitis; Postoperative Complications; Radiography, Interventional; Retrospective Studies; Technetium Tc 99m Lidofenin; Tomography, X-Ray Computed; Ursodeoxycholic Acid

Topics: Bile Ducts; Humans; Imino Acids; Liver; Pancreatitis; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

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

Topics: Adult; Aged; Biliary Tract; Chronic Disease; Female; Humans; Imino Acids; Liver; Middle Aged; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis; Radionuclide Imaging; Recurrence; Technetium; Technetium Tc 99m Lidofenin

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

Endoscopic retrograde cholangiography (ERCP), the most advanced of the gastrointestinal endoscopic procedures, provides both specific diagnostic information pertaining to diseases of the biliary tract and pancreas and definitive therapy available only with this modality. ERCP is safe and accurate, establishing a primary diagnosis in 80% of cases and, in experienced hands, cannulation is successful in 98%. In addition to cholangiography, pancreatography has been a significant achievement providing accurate diagnostic yield through direct cannulation and opacification of the pancreatic duct while permitting collection of secretions for cytological evaluation and chemical analyses. The therapeutic extension of ERCP, endoscopic papillotomy (EPT), is successful in 94% of cases in the treatment of common bile duct stones and papillary stenosis, providing comparable results to surgical procedures while reducing morbidity, mortality and convalescence. Because of the accuracy and safety of these procedures, they should be considered early in suspected diseases of the biliary tract and pancreas so that the clinician can establish a specific diagnosis and provide definitive therapy.

Topics: Biliary Tract Diseases; Cholangiopancreatography, Endoscopic Retrograde; Cholecystectomy; Cholestasis, Extrahepatic; Cholestasis, Intrahepatic; Gallbladder Diseases; Humans; Imino Acids; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis; Postoperative Complications; Technetium; Technetium Tc 99m Lidofenin