Clinical History
Abdominal pain, bile leak.
Technique
The patient was administered 2 millicuries of Tc 99m Choletec and multiple dynamic images were obtained.
There is normal uptake of activity by the liver. Activity is identified in the region of the common bile duct by
ten minutes. The patient has had a recent cholecystectomy; therefore, the gallbladder is not visualized.
Findings
During the 90 minutes of further imaging, there is continued pooling of activity over the left lobe of the liver.
There is a lack of normal small bowel visualization, with persistent activity remaining superimposed over the
liver. This finding would be consistent with an area of a bile leak.
Impressions
FINDINGS OF PROMPT EXCRETION BY THE LIVER; HOWEVER, THERE IS ACCUMULATION
OF LABELED ACTIVITY SUPERIMPOSED OVER THE LEFT LOBE OF THE LIVER, WITHOUT
NORMAL SMALL BOWEL ACTIVITY, SUGGESTING A BILE LEAK IN THIS AREA. IF
CLINICALLY INDICATED, CT OR SONOGRAPHY MAY BE USEFUL FOR FURTHER
EVALUATION.
Comments
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