Presentation
Right upper quadrant pain.
Patient Data
Following IV administration of technetium-99m trimethylbromide, there is prompt, homogenous concentration of radiotracer in the liver of normal intensity. The liver is normal in size, position, and shape. Subsequent images show prompt excretion of tracer into the biliary tract, small bowel, and gallbladder.
Following the administration of cholecystokinin, the gallbladder contracts normally. The gallbladder ejection fraction is 79% at 60 minutes. Normal range is >38% at any time point.
Case Discussion
Acute cholecystitis is caused by cystic duct obstruction. Failure of radiotracer to enter the gallbladder is most often due to obstruction of the duct. This is a beautiful example of a normal HIDA scan with prompt visualization of the gallbladder and normal emptying after cholecystokinin administration.
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