title: False-negative morphine-augmented hepatobiliary scintigraphy with a rim sign.
abstract: A patient with cholelithiasis and clinically suspected of acute cholecystitis underwent hepatobiliary scintigraphy that demonstrated initial nonvisualization of the gallbladder in association with a subtle rim sign, but subsequent gallbladder visualization after administration of intravenous morphine. After an 8-day period of medical management, an elective cholecystectomy was performed, which revealed a gangrenous gallbladder with a gallstone in the neck and full thickness necrosis. These results suggest that gallbladder visualization on morphine-augmented hepatobiliary scintigraphy should be interpreted cautiously in the presence of a rim sign because acute cholecystitis remains a possibility.
authors.affiliation: Department of Veterans Affairs Medical Center, Seattle, Washington 98108, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: Jacobson
mesh_terms: D001659:Biliary Tract / Q000000981:diagnostic imaging*; D002764:Cholecystitis / Q000000981:diagnostic imaging*; D005188:False Negative Reactions; D005704:Gallbladder / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009020:Morphine; D011877:Radionuclide Imaging
chemical_list: D009020:Morphine