Gallbladder dysfunction

Case contributed by Dr Matthew Lukies

Presentation

Ongoing right upper quadrant pain particularly after meals. Normal ultrasound with no cholelithiasis.

Patient Data

Age: 35
Gender: Female
Nuclear medicine
  • Radiotracer activity seen in the gallbladder, biliary system and duodenum
  • Reduced rate of gallbladder emptying, with a gallbladder ejection fraction of 22% (Normal > 33% for this protocol)

The impaired gallbladder emptying is compatible with gallbladder dysfunction.

Case Discussion

This cholescintigraphy (HIDA) scan was performed with 75 MBq of Tc-99m given IV, with imaging commenced at 1 hr and an oral fat-rich meal given to stimulate gallbladder contraction. Radiotracer activity in the gallbladder is measured over time as the gallbladder empties through the cystic duct, assessing gallbladder function. A normal gallbladder ejection fraction under this protocol is > 33%.

The patient in this case proceeded to cholecystectomy. Histopathology revealed patchy, light chronic inflammation with Rokitansky-Aschoff sinus formation.

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Case information

rID: 46882
Case created: 21st Jul 2016
Last edited: 23rd Jan 2017
Inclusion in quiz mode: Included

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