technetium-tc-99m-mebrofenin and Rupture--Spontaneous

Chilaiditi sign is the incidental radiologic finding of intestinal interposition between the liver and diaphragm, whereas Chilaiditi syndrome describes the presence of accompanying clinical symptoms including abdominal pain, constipation, vomiting, and respiratory distress. We describe a case of radiotracer accumulation over the liver dome on Tc-mebrofenin hepatobiliary scan performed on a 72-year-old man with acute cholecystitis mimicking a bile leak. However, chest radiograph and CT revealed intestinal hepatodiaphragmatic interposition. This case illustrates the importance of being familiar with the scintigraphic appearance of the Chilaiditi sign and correlating abnormal nuclear medicine scan findings with other available radiologic modalities.

Topics: Aged; Aniline Compounds; Bile; Chilaiditi Syndrome; Cholecystitis, Acute; Cholecystostomy; Diagnosis, Differential; Diaphragm; Gallbladder Diseases; Glycine; Humans; Imino Acids; Liver; Male; Organotechnetium Compounds; Radiography, Thoracic; Radiopharmaceuticals; Rupture, Spontaneous; Tomography, X-Ray Computed

Intrabiliary rupture is the most common complication of hepatic hydatid cyst yet it is unusual, occurring in only 3-17% of cases. The diagnosis is rarely difficult on ultrasound and CT when typical radiological features are present. In rare cases of complete evacuation, when characteristic findings of hydatid cyst are absent or when there is no evidence of the previous existence of liver hydatid cyst, the diagnosis may be difficult. In difficult cases, MRI, MRCP, ERCP and (99)Tc(m)-mebrofenin hepatobiliary scintigraphy are employed. We present a rare case of surgical obstructive jaundice due to rupture of a liver hydatid cyst into the biliary tract and gall bladder, with complete evacuation of its contents leading to misdiagnosis on CT and ultrasound. MRCP and (99)Tc(m)-mebrofenin hepatobiliary scintigraphy were able to establish a firm pre-operative diagnosis.

Topics: Aniline Compounds; Biliary Tract Diseases; Diagnosis, Differential; Echinococcosis, Hepatic; Gallbladder Neoplasms; Glycine; Humans; Imino Acids; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Organotechnetium Compounds; Rupture, Spontaneous; Tomography, X-Ray Computed

A 2-month-old infant had jaundice that began 3 days after birth. The clinical features were suggestive of biliary obstruction. Tc-99m mebrofenin hepatobiliary imaging confirmed the diagnosis of spontaneous perforation of the common bile duct, and surgical intervention resulted in progressive recovery.

Topics: Aniline Compounds; Common Bile Duct Diseases; Glycine; Humans; Imino Acids; Infant; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Rupture, Spontaneous

Topics: Aged; Aged, 80 and over; Aniline Compounds; Cholecystitis; Gallbladder; Glycine; Humans; Imino Acids; Male; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Rupture, Spontaneous; Tomography, X-Ray Computed; Ultrasonography

The gallbladder and an infected pericholecystic biloma secondary to subacute perforation were visualized during morphine-augmented cholescintigraphy. Perforation of the gallbladder may relieve cystic duct obstruction and contribute to false-negative visualization in the setting of acute cholecystitis.

Topics: Aniline Compounds; Cholecystitis; False Negative Reactions; Gallbladder Diseases; Glycine; Humans; Imino Acids; Male; Middle Aged; Morphine; Organotechnetium Compounds; Radionuclide Imaging; Rupture, Spontaneous