technetium-tc-99m-mebrofenin and Abdominal-Pain

Topics: Abdominal Pain; Adult; Aniline Compounds; Cholangiopancreatography, Magnetic Resonance; Digestive System Abnormalities; Female; Gallbladder; Glycine; Humans; Imino Acids; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Ultrasonography

Surgical sphincteroplasty (SS) for sphincter of Oddi dysfunction (SOD) can be performed primarily or following failed endoscopic therapy. The role of SS in an era of endoscopic management is unclear. This study presents long-term follow-up of patients who had undergone SS at a tertiary referral unit.. Patients were identified from a departmental database and sent post-operative questionnaires to review pain scores and satisfaction with the procedure. Indications, pre-operative interventions and complications were recorded.. Seventeen patients underwent SS over 13 years. Thirteen patients had objective features of biliary obstruction (delayed excretion of isotope or elevated sphincter pressures). The positive predictive value, sensitivity and specificity of morphine 99mTc-TBIDA in this series was 100, 100 and 92%, respectively. There were 12 responders of whom all but one had symptomatic improvement. Median follow-up was 5.1 years. Pain was significantly lower following SS (16 ± 9 vs. 67 ± 11; p = 0.003) and median satisfaction with the procedure was high (95%).. Excellent symptomatic pain relief following SS can be achieved in carefully selected patients. Manometry does not appear to be essential for diagnosing SOD and morphine provocation hepatic scintigraphy was used to reliably identify patients who would benefit from SS.

Topics: Abdominal Pain; Adult; Analgesics, Opioid; Aniline Compounds; Female; Follow-Up Studies; Glycine; Humans; Imino Acids; Male; Middle Aged; Morphine; Organotechnetium Compounds; Pain Measurement; Patient Satisfaction; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Sphincter of Oddi Dysfunction; Sphincterotomy, Transduodenal; Surveys and Questionnaires; Time Factors

To explore the extension of cholecystokinin-cholescintigraphy in the evaluation of abdominal pain.. A total of 1554 patients with abdominal pain underwent Tc-mebrofinin cholescintigraphy. Gallbladder ejection fraction was obtained with cholecystokinin (sincalide) and abdominal pain was graded.. Fourteen different types of hepatobiliary and gastrointestinal motility disorders were identified. Biliary dyskinesia was found in 453 patients, septate gallbladder in 33, and duodeno-gastric bile reflux in 46 patients. Sincalide-induced intestinal hyperperistalsis alone was found in 65 and in combination with other diseases in 64 patients. Abdominal pain was mild to moderate in intensity, and occurred in 50-60% of patients with abnormal gallbladder function. Severe abdominal pain was usually associated with intestinal hyperperistalsis.. Tc-mebrofinin cholescintigraphy enables the identification of motility disorders of the gastrointestinal and hepatobiliary tract, and post-sincalide abdominal pain in most cases can be assigned to functional abnormality of the gallbladder or/and intestine.

Topics: Abdominal Pain; Aniline Compounds; Biliary Tract; Female; Gastrointestinal Tract; Glycine; Humans; Imino Acids; Liver; Male; Organotechnetium Compounds; Radionuclide Imaging; Sincalide

The effects of folds or septa on gallbladder filling and emptying are not known.. Gallbladder filling and emptying were measured in seven patients with two chambers (segmental) and compared with 10 subjects with a single chamber (control). Percent bile flow into gallbladder, and percent ejection fraction from the proximal and distal segments, and entire gallbladder were measured with cholecystokinin.. Bile entry into gallbladder was similar in both groups. In patients with segmentation, overall emptying was low mostly due to poor emptying of the distal segment.. Segmentation of the gallbladder does not affect bile entry, but acting as a one-way valve, a fold or septum lowers emptying significantly, mostly from the distal segment.

Topics: Abdominal Pain; Adolescent; Adult; Aged; Aniline Compounds; Case-Control Studies; Epithelium; Female; Gallbladder; Gallbladder Emptying; Glycine; Humans; Imino Acids; Male; Middle Aged; Organotechnetium Compounds; Radiopharmaceuticals; Ultrasonography

The purpose of this study was to examine whether gallbladder function as assessed by a hepatobiliary scintigraphy was related to the symptomatology in gallstone patients and to the outcome 1 year after either cholecystectomy or watchful waiting. The study included 100 patients with uncomplicated gallstone disease. Fifty-six patients had a functioning gallbladder and 44 had a nonfunctioning gallbladder. Patients with a nonfunctioning gallbladder had significantly more vomiting and received more pain-killing injections during pain attacks. Otherwise, there were no differences in pain patterns or characteristics of dyspeptic symptoms in relation to gallbladder function. In patients with a functioning gallbladder, there were no significant differences between the group of patients with impaired and normal gallbladder function. Cholecystectomy was performed in 69 patients and at the 1-year follow-up; 22% continued to have pain attacks, but this was not related to the gallbladder function preoperatively. In 31 patients without cholecystectomy, 14 patients became asymptomatic within a 1-year follow-up. However, this was not related to gallbladder function. In conclusion, gallbladder function evaluated by a hepatobiliary scintigraphy was not related to the symptoms in gallstone patients, and was not related to the occurrence of symptoms after cholecystectomy or watchful waiting.

Topics: Abdominal Pain; Adult; Aged; Aniline Compounds; Cholecystectomy; Cholecystolithiasis; Dyspepsia; Female; Glycine; Humans; Imino Acids; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Treatment Outcome

Topics: Abdominal Pain; Acalculous Cholecystitis; Acute Disease; Aniline Compounds; Fever; Gallbladder; Glycine; Humans; Imino Acids; Male; Middle Aged; Organotechnetium Compounds; Pancreatitis; Parenteral Nutrition, Total; Posture; Radionuclide Imaging; Radiopharmaceuticals; Supine Position; Ultrasonography

Topics: Abdomen; Abdominal Pain; Aniline Compounds; Appendicitis; Carcinoma, Squamous Cell; Diagnosis, Differential; Glycine; Humans; Imino Acids; Liver Neoplasms; Mesenteric Veins; Organotechnetium Compounds; Radionuclide Imaging; Sensitivity and Specificity; Splanchnic Circulation; Tomography, X-Ray Computed; Varicose Veins

Topics: Abdominal Pain; Adult; Aniline Compounds; Artifacts; Cholelithiasis; Colon; Diagnosis, Differential; Gallbladder; Glycine; Humans; Imino Acids; Male; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Ultrasonography