Biliary complications of gallstone lithotripsy detected by Tc-99m DISIDA scintigraphy.
Extracorporeal shock wave lithotripsy (ESWL) has been reported to be a safe and relatively effective non-invasive treatment for radiolucent gallbladder calculi in selected patients. Ideally, the goal of successful treatment is the passage of all fragments from the gallbladder into the intestinal tract. Biliary colic has been reported in up to 35% of treated patients, although complications such as cholecystitis, cholangitis, common bile duct obstruction, and pancreatitis are surprisingly infrequent. Cholescintigraphy is the procedure of choice in patients with biliary colic and suspected acute cholecystitis. It has proven to be more sensitive than ultrasound in detecting acute common bile duct (CBD) obstruction, since functional obstruction precedes morphologic dilatation of the CBD. This report reviews two cases of post-lithotripsy cystic and common duct obstruction and discusses the role of Tc-DISIDA scintigraphy following gallstone ESWL.
St George
J K
JK
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia.
Velchik
M G
MG
D000328:Adult; D002769:Cholelithiasis / Q000628:therapy*; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging* / Q000209:etiology; D003137:Common Bile Duct Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D003549:Cystic Duct / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007098:Imino Acids; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019785:Technetium Tc 99m Disofenin
D007098:Imino Acids; D015609:Organotechnetium Compounds; D019785:Technetium Tc 99m Disofenin