Right upper quadrant pain with normal hepatobiliary ultrasound: Can hepatobiliary scintigraphy define the cause? Full Text
Saudi Journal of Gastroenterology, 07/27/2012
Othman SA – Hepatobiliary scintigraphy (HS) with fatty meal stimulation and GB ejection fraction (GBEF) estimation seems to be a reliable test, which may reveal a biliary cause in more than 70% of patients with RUQ abdominal pain and normal HU. Normal results exclude functional biliary cause. The decision for invasive or noninvasive therapeutic approach may depend on the results of HS.
Methods- Authors reviewed the HS results of 30 patients, aged 29–69 years (average 45.8 years); 12 male and 18 female patients.
- Patient selection to perform the HS was RUQ abdominal pain, suspected hepatobiliary disorder, and negative HU.
- All patients had gone through the standard procedure of HS.
- Based on predefined interpretation criteria, HS results were divided into 2 patterns: Normal (n=8, 25.8%) and abnormal (n=22, 73%): 18 patients (81.8%) having early gallbladder (GB) and common bile duct visualization, and delayed transit to small bowel (SB), which can be seen only after a fatty meal with normal or abnormal GB ejection fraction (GBEF) pattern characteristic of Oddi's sphincter dyskinesia.
- The remaining 4 patients (8.18%) had acalculous cholycystitis pattern: Delayed GB visualization with activity appearing in SB before GB.
