THE VALUE OF HIDA IMAGING IN ACALCULUS RIGHT UPPER QUADRANT PAIN: “SPIN THE WHEEL, VANNA”!

Thomas A. Ruffolo, Glen A. Lehman

Research output: Contribution to journalArticle

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Abstract

This study attempted to determine the diagnostic value of the cholecystokinin (CCK)‐stimulated HIDA scan in the evaluation of patients with chronic, acalculus right upper quadrant pain, clinically suggestive of biliary colic, hut with negative ultrasound examinations. The authors compared the ability of the gallbladder to eject a radionuclide, with the relief of pain following cholecystectomy and the degree of gallbladder inflammation seen on histology. They tested the hypothesis that chronic inflammation of the gallbladder would lead to poor gallbladder contractility and a diminished ejection fraction (EE) on cholescintigraphy. In addition, patients with low gallbladder EEs would he expected to have more extensive inflammatory changes on histopathology, and have a higher probability of a good clinical outcome following cholecystectomy. Twenty‐six patients who had undergone CCK cholescintigraphy for evaluation of chronic right upper quadrant pain without evidence of gallstones on ultrasound, later underwent cholecystectomy. Eighteen of the patients (69%) were considered therapeutic successes, whereas eight patients (31%) were failures after an average 2‐yr follow‐up. Both “patient‐outcome” groups had significantly reduced EEs by the author's criteria. Only five patients in the success group and two in the failure group had histological evidence of chronic cholecystitis. No difference in the EF was observed in subjects with chronic acalculus cholecystitis versus those with normal histology. The authors concluded that low gallbladder EE does not predict clinical outcome (as assessed by CCK‐stimulated HIDA scan) and that the EE is not predictive of histology. In summary, the diagnostic value of biliary cholescintigraphy in the evaluation of chronic acalculus right upper quadrant pain was felt to be poor.

Original languageEnglish (US)
Pages (from-to)375-376
Number of pages2
JournalThe American journal of gastroenterology
Volume86
Issue number3
DOIs
StatePublished - Mar 1991

Fingerprint

Cholecystitis
Gallbladder
Pain
Cholecystectomy
Histology
Cholecystokinin
Aptitude
Colic
Gallstones
Radioisotopes
lidofenin
Therapeutics

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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THE VALUE OF HIDA IMAGING IN ACALCULUS RIGHT UPPER QUADRANT PAIN : “SPIN THE WHEEL, VANNA”! / Ruffolo, Thomas A.; Lehman, Glen A.

In: The American journal of gastroenterology, Vol. 86, No. 3, 03.1991, p. 375-376.

Research output: Contribution to journalArticle

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abstract = "This study attempted to determine the diagnostic value of the cholecystokinin (CCK)‐stimulated HIDA scan in the evaluation of patients with chronic, acalculus right upper quadrant pain, clinically suggestive of biliary colic, hut with negative ultrasound examinations. The authors compared the ability of the gallbladder to eject a radionuclide, with the relief of pain following cholecystectomy and the degree of gallbladder inflammation seen on histology. They tested the hypothesis that chronic inflammation of the gallbladder would lead to poor gallbladder contractility and a diminished ejection fraction (EE) on cholescintigraphy. In addition, patients with low gallbladder EEs would he expected to have more extensive inflammatory changes on histopathology, and have a higher probability of a good clinical outcome following cholecystectomy. Twenty‐six patients who had undergone CCK cholescintigraphy for evaluation of chronic right upper quadrant pain without evidence of gallstones on ultrasound, later underwent cholecystectomy. Eighteen of the patients (69{\%}) were considered therapeutic successes, whereas eight patients (31{\%}) were failures after an average 2‐yr follow‐up. Both “patient‐outcome” groups had significantly reduced EEs by the author's criteria. Only five patients in the success group and two in the failure group had histological evidence of chronic cholecystitis. No difference in the EF was observed in subjects with chronic acalculus cholecystitis versus those with normal histology. The authors concluded that low gallbladder EE does not predict clinical outcome (as assessed by CCK‐stimulated HIDA scan) and that the EE is not predictive of histology. In summary, the diagnostic value of biliary cholescintigraphy in the evaluation of chronic acalculus right upper quadrant pain was felt to be poor.",
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