Hepatobiliary scintigraphic findings in obstructed intrahepatic choledochal cyst before and after surgery.
The authors describe a 10-week-old boy who presented with symptoms of progressive obstructive jaundice and abdominal distension. Clinical examination revealed gross hepatomegaly. A preoperative Tc-99m mebrofenin hepatobiliary study showed a large photopenic area involving the entire right lobe of the liver that did not communicate with the biliary system. Ultrasonography revealed a huge cystic mass with a few intracystic septae involving nearly the entire liver parenchyma. Under ultrasound guidance, a pigtail catheter was inserted into the cyst and produced free drainage of bile-stained fluid. Subsequently, an obstructed choledochal cyst was diagnosed clinically, and a right hepatectomy followed by a Roux-en-Y loop implantation on the raw surface of the left lobe were performed. Serial postoperative Tc-99m mebrofenin hepatobiliary studies showed marked improvement in liver function and biliary drainage with significant regeneration of the liver parenchyma.
Kumar
R
R
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi. rkphulia@hotmail.com
Choudhury
S
S
Dasan
B
B
Agarwala
S
S
Malhotra
A
A
D000713:Anastomosis, Roux-en-Y; D000814:Aniline Compounds; D015529:Choledochal Cyst / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D002779:Cholestasis / Q000209:etiology; D005998:Glycine; D006498:Hepatectomy; D006801:Humans; D007098:Imino Acids; D007223:Infant; D008297:Male; D015609:Organotechnetium Compounds; D011182:Postoperative Care; D011300:Preoperative Care; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C034837:technetium Tc 99m mebrofenin; D005998:Glycine