Presentation
Episodic moderate right upper quadrant pain, but not acutely unwell. Biliary sludge without calculi seen on ultrasound.
Patient Data
radiotracer activity and passage seen through the liver, bile duct and duodenum
no radiotracer activity in the gallbladder (over 90 min)
The absence of radiotracer filling of the gallbladder in this clinical setting is compatible with chronic cholecystitis.
Case Discussion
This cholescintigraphy scan was performed after a 4-hour fast with 200 MBq of Tc-99m DISIDA given IV, and imaging taken over 1.5 hrs. The absence of gallbladder filling precluded fat-rich meal stimulation and gallbladder function assessment.
The patient in this case proceeded to cholecystectomy. Histopathology confirmed the diagnosis of chronic acalculous cholecystitis.