Bile leak detection by radionuclide scintigraphy.
BACKGROUND
Bile leak after liver injury has been reported to be a complication associated with significant mortality. Tc99m-IDA (Tc: Technetium) nuclear scan allows rapid and noninvasive diagnosis of bile leak.


OBJECTIVE
An accidental case was referred for the detection of suspicious bile leak.


METHODS
The ultrasound could not detect any abnormality. Dynamic Hepatobiliary Scintigraphy (DHBS) using radiolabeled tracer was performed.


RESULTS
DHBS promptly detected the site of leak.


CONCLUSIONS
This technique should be opted because it has been found to be quite sensitive, specific and accurate for detecting the bile leak, whereas, Ultrasound and CT imaging are less sensitive and nonspecific. Though, they are initially helpful in determining the presence of abdominal fluid collections, they are unable to differentiate between a seroma, lymphocele, hematoma or bile leak. Hepatobiliary scintigraphy is more accurate because it can demonstrate continuity of these fluid collections with the biliary tree. Further, hepatobiliary scintigraphy can provide real-time assessment of hepatocytes function and bile progression from the liver to the intestine.
Gupta
V
V
Nuclear Medicine and Thyroid Physician, Amritsar, India. drvjg@yahoo.com
D000328:Adult; D001646:Bile / Q000000981:diagnostic imaging*; D006801:Humans; D007098:Imino Acids; D008099:Liver / Q000000981:diagnostic imaging* / Q000293:injuries*; D008297:Male; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
D007098:Imino Acids; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C046767:technetium Tc 99m iminodiacetic acid