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Query: UMLS:C0149520 (acute cholecystitis)
 2,784 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The hepatobiliary transit of 99mTc-diethyl-IDA was studied in 50 cases of acute cholecystitis. The intrahepatic transit was characterized by the liver mean transit time of the tracer. The extrahepatic passage through the biliary tract was assessed from a series of scintigrams. The data were classified according to previously obtained knowledge of normal and pathological states of the liver and the biliary tract. (Normal liver mean transit time less than or equal to 70 minutes, normal appearance-time of the tracer in the biliary tract less than or equal to 15 minutes and in the intestine less than or equal to 20 minutes, no retention of the tracer in the biliary tract in cases of later appearance-times). Abnormal hepatobiliary transit of the tracer was recorded in 27 cases; it was retarded at the intrahepatic level in 11 cases, at the gallbladder neck in 3 cases, distally in the biliary tract in 12 cases, and a tight extrahepatic obstruction was seen in 1 case. In consequence, acute cholecystitis is often associated with disturbed hepatobiliary function. The functional changes in acute cholecystitis were similar to those associated with other hepatobiliary disorders of either intrahepatic or extrahepatic origin.
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PMID:Cholescintigraphy in the determination of disturbed hepatobiliary function in acute cholecystitis. 51 94

Technetium-99-m-diethyl-IDA (Solco HIDA) cholescintigraphy was performed on 50 patients with suspected acute cholecysitis. The final diagnosis was acute cholecytitis in 34 cases, other biliary tract disease in 5 cases and nonbiliary disease in 11 cases. A nonfilling gallbladder was regarded as indicative of acute cholecystitis. The sensitivity in detecting acute cholecystitis was about 90%, the specificity about 80%; the predictive value of a positive test was about 90% and that of a negative test about 80%. The false positives consisted of two cases of acute pancreatitis with normal gallbladders and one case of coincidental chronic gallbladder disease and duodenal ulcer. The false negatives were examined after one week's treatment. A severe common bile duct obstruction could be detected in cholescintigraphy, but a slight obstruction was not always distinguishable from conditions in which the bile flow was normal.
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PMID:Cholescintigraphy in the diagnosis of acute cholecystitis. 70 72

The diagnostic yields of intravenous cholangiography (IVC) and 99mTc-diethyl-IDA cholescintigraphy (CS) were compared in 50 patients; 19 had acute cholecystitis, 5 pancreatitis, 4 obstructive disease of the common bile duct, 5 chronic gallbladder disease, 6 parenchymal liver disease and 11 had other intra-abdominal diseases. The comparison of IVC and CS covered three aspects: the definition of the biliary tract structures, their morphologic changes and an assessment of bile flow through the cystic duct and the common bile duct. The definition of the main intrahepatic bile ducts was better with IVC; that of the common bile duct and the gallbladder was better with CS. Morphologic details such as calculi or local changes in duct calibre were detected only in IVC. Measurements of common bile duct calibre obtained from operative cholangiograms correlated better with those from the IVCs than with those from the CSs. CS was more sensitive in the diagnosis of cystic duct obstruction. Bile flow in the common bile duct was estimated in the cases where the gallbladder did not fill. Delayed emptying of the common bile duct was revealed in IVC in 1 and in CS in 3 out of 6 cases with disturbed bile flow. The morphologic findings in IVC gave indication of the obstructive condition in the 1 case with retarded flow and in 2 additional cases. CS provided functional information for which the concentration of the tracer was sufficient except in one case. IVC provided morphologic and functional information, but the excretion of the contrast medium was insufficient for a morphologic assessment of the common bile duct in 16 cases and for a functional assessment in 11 cases.
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PMID:Intravenous cholangiography and cholescintigraphy in the diagnosis of hepatobiliary disease. 73 87

99mTc-IDA (99mTc-dimethyl-acetanilide-iminodiacetic acid) hepato-biliary imaging was evaluated for its efficacy in distinguishing acute cholecystitis from acute pancreatitis. In a retrospective review, gallbladders were demonstrated by 99mTc-IDA in 13 of 15 patients (87%) with acute pancreatitis. This is significantly higher than reports on the frequency of gallbladder filling with oral and intravenous cholangiography in the presence of acute cholecystitis.
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PMID:99mTc-IDA imaging in the differential diagnosis of acute cholecystitis and acute pancreatitis. 76 Jan 73

Failure to visualize the gallbladder in its usual location along the right inferior hepatic border suggests many possibilities including acute cholecystitis. The case described here reveals the importance of proper protocol for hepatobiliary imaging with 99mTC-IDA agents, the necessity of quantification of function as an integral part of imaging to enable proper differential diagnosis. A case of bilobed gallbladder presenting as a Valentine heart in an unusual location in the liver is described. The measurement of the CCK-8 induced gallbladder ejection fraction for each lobe facilitated proper diagnosis.
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PMID:Identification and differentiation of congenital gallbladder abnormality by quantitative technetium-99m IDA cholescintigraphy. 174 Jul 14

A patient's clinical presentation should prompt an imaging evaluation that is cost effective for accurate diagnosis and leads to appropriate treatment of gallbladder inflammatory disease. In the setting of recurrent biliary colic, chronic cholecystitis is the main diagnostic consideration. Imaging hallmarks include gallstones and gallbladder wall thickening for which ultrasonography is uniquely suited. When a patient appears more toxic with right upper quadrant pain, one would more strongly consider acute cholecystitis. Because the morbidity and mortality of acute cholecystitis are reduced with early cholecystectomy, it is incumbent upon the clinician to make the diagnosis promptly and accurately. Hepatobiliary imaging with an IDA derivative has proven superior sensitivity, specificity, and accuracy for this condition. The examination has validity because it detects cystic duct obstruction, the primary pathophysiologic event responsible for most acute calculous and acalculous disease. Utilizing morphine augmentation when delayed filling is present has reduced the total examination time to less than 2 hours. Use of ancillary findings including gallbladder hyperemia and the "hot rim" sign help predict complicated cholecystitis, enabling more urgent intervention. The bulk of data presented in this review supports hepatobiliary imaging as the modality of first choice in the evaluation of acute cholecystitis. In the intensive care setting, where acalculous disease and atypical presentations are common, hepatobiliary imaging also plays a major role. We recommend liberal use of Sincalide pretreatment, morphine augmentation, and delayed images to promote gallbladder filling. If the gallbladder is nonvisualizing despite these maneuvers, sonography is often added as an aid to detect secondary signs of acute cholecystitis and help confirm the diagnosis with greater certainty prior to high-risk surgery.
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PMID:Hepatobiliary imaging. 191 52

34 patients admitted for suspected acute cholecystitis were evaluated using 99mTc IDA cholescintigraphy. The results of these studies are reviewed and compared with other diagnostic tests and the subsequent clinical diagnosis. Cholescintigraphy proved to be a safe, simple, highly accurate and sensitive technique. Therefore, 99mTc-IDA cholescintigraphy is proposed as the initial procedure of choice in the evaluation of patients with suspected acute cholecystitis.
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PMID:[Acute cholecystitis. Early diagnostic study using cholescintigraphy with Tc99m-IDA]. 233 59

Increased hepatic activity surrounding the gallbladder fossa during Tc-99m SC liver imaging was observed. Subsequent Tc-99m IDA biliary imaging showed similar findings in the face of nonvisualization of the gallbladder--the classic "rim sign." Surgery confirmed the diagnosis of complicated acute cholecystitis. This case indicates that a rim sign may be seen with either Tc-99m SC or Tc-99m IDA imaging and may have the same diagnostic significance in both.
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PMID:The diagnosis of acute complicated cholecystitis by Tc-99m sulfur colloid liver imaging. 234 Jun 56

We have reviewed the experience of our institution and the literature concerning the use of hepatobiliary scintigraphy for the diagnosis of acute cholecystitis. The aim of this study was to assess whether the hepatobiliary scintigraphic finding of initial gallbladder visualization within 30 min is a more reliable criterion for excluding acute cholecystitis than gallbladder visualization within 1 h after tracer injection. In our institution's consecutive series, 113 of 211 hepatobiliary studies had gallbladder visualization within 1 h. Gallbladder visualization time in this group had a log normal distribution, with gallbladder visualization occurring within 30 min in 107 of 113 (95%). Gallbladder visualization occurred between 31 and 60 min in only 6 (5%); nevertheless, our one false negative study came from this small subgroup of patient studies (P = 0.05). Review of the literature (1645 patients with iminodiacetic acid [99mTc-IDA] derivative studies) revealed 6 further timed false negative results with gallbladder visualization within 1 h. Of these studies, in 4 (67%) the gallbladder was visualized between 31 and 60 min and in only 2 before 30 min. One of these latter 2 patients had a rare anatomy. Analysis of the pooled institutional and literature data gave an estimated false negative rate of 21% if the gallbladder was visualized between 31 and 60 min. This was significantly higher (P less than 0.001) than the 0.5% false negative rate when the gallbladder was seen prior to 30 min, but similar to the false negative rate of 16% reported by Weissmann et al. for studies with initial visualization after 1 h.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Association between false negative hepatobiliary scans and initial gallbladder visualization after 30 min. 238 11

Hepatobiliary scans using Tc-IDA are reliable in making the diagnosis of acute cholecystitis. Commonly, opioid drugs are administered in patients with acute cholecystitis to relieve pain. Opioid drugs cause biliary sphincter spasm. Whether these drugs adversely affect hepatobiliary scans is unknown. We studied 13 healthy volunteer subjects, performing three hepatobiliary scans in each one. Scans were performed without opioid drugs and 30 minutes after intramuscularly administered meperidine, morphine, hydroxyzine, hydroxyzine plus meperidine, butorphanol, and nalbuphine. Opioid drugs markedly delayed clearance of Tc-IDA from the common bile duct, simulating common bile duct obstruction. Hydroxyzine alone caused an insignificant delay. We have concluded that opioid drugs cause bile duct obstruction in healthy persons. If opioid drugs are administered before a diagnostic hepatobiliary scan, delayed clearance of Tc-IDA from the common bile duct might lead to an erroneous diagnosis and indicate a potentially unnecessary common bile duct exploration. Opioid drugs should not be administered for several hours before a diagnostic hepatobiliary scan.
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PMID:Opioid drugs cause bile duct obstruction during hepatobiliary scans. 653 76


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