technetium-tc-99m-sulfur-colloid and Cholelithiasis

The interaction between the various noninvasive and invasive imaging modalities used to evaluate the liver, biliary tract, and pancreas is demonstrated in this article. By understanding this interaction and correlating noninvasive studies, the clinician will avoid diagnostic redundancy and the need for invasive testing may be reduced.

Topics: Adenocarcinoma; Biliary Tract Diseases; Biopsy, Needle; Cholangiography; Cholecystectomy; Cholelithiasis; Cholestasis; Diagnosis, Differential; Hepatectomy; Humans; Liver; Liver Diseases; Liver Neoplasms; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

Intrahepatic cholelithiasis is commonly associated with suppurative cholangitis and occurs equally in males and females. Patients usually present with a history of recurrent symptoms and a differential diagnosis which includes viral hepatitis, pancreatitis, myocardial infarction and perforated ulcer. Cholangiography including stereocholangiography is essential for localizing intrahepatic stones and ductal strictures. The guiding operative principle is to drain all infected bile distal to ducts obstructed with stones or stricture. This may also necessitate a bilioenterostomy with or without partial hepatic resection. Although these procedures are formidable in an acutely ill patient, a more simple but inappropriate choledocholithotomy and t-tube drainage done proximal to an obstructed intrahepatic duct will be ineffective and may result in continued sepsis and death.

Topics: Adult; Bile Ducts, Intrahepatic; Cholangiography; Cholangitis; Cholelithiasis; Cholestasis, Intrahepatic; Diagnosis, Differential; Drainage; Female; Humans; Male; Technetium Tc 99m Sulfur Colloid; Ultrasonography

Topics: Aged; Cholangiography; Cholelithiasis; Common Bile Duct; Gallium Radioisotopes; Humans; Male; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid