title: Dumbbell Gallbladder Cholecystitis on Tc-99m Diisopropyliminodiacetic acid Hepatobiliary Imaging.
abstract: We present a case of a 79-year-old immunocompromised female admitted for abdominal pain and sepsis, who had an abdominal computed tomography (CT) showing distal gallbladder fundus wall thickening, pericholecystic edema, and a right posteroinferior hepatic abscess. Subsequent hepatobiliary scintigraphy with Tc-99m diisopropyliminodiacetic acid showed gallbladder filling of the proximal gallbladder fundus, yet no radiotracer filling of the distal gallbladder fundus. Further correlation with the initial CT showed a partial gallbladder stricture and a resultant altered morphology resembling a dumbbell-shaped gallbladder. Percutaneous cholangiogram also confirmed this dumbbell morphology. Nonfilling of radiotracer into the distal end of the dumbbell gallbladder correlating with CT findings of focal gallbladder inflammation indicated that there was a focal inflammation suggesting a distal dumbbell gallbladder cholecystitis. This case demonstrates a unique finding of focal inflammatory pathology involving an anatomic variant - the dumbbell-shaped gallbladder, and the challenges this anatomic variant presents in hepatobiliary scintigraphy image interpretation.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
authors.forename: Asif Ali
authors.initials: AA
authors.lastname: Fakhri
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
authors.forename: Paul David
authors.initials: PD
authors.lastname: Rodrigue
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
authors.forename: Aun
authors.initials: A
authors.lastname: Hussain
authors.affiliation: Department of Biological Sciences, New Jersey Institute of Technology, New Jersey, USA.
authors.forename: Abbas
authors.initials: A
authors.lastname: Taiyebi
keywords: Cholecystitis; Tc-99m diisopropyliminodiacetic acid; dumbbell gallbladder; gallbladder stricture; hepatobiliary imaging