Publication: Bile leak detection by radionuclide scintigraphy
Date
2006
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Introduction: 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.
Conclusion: 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.
Key words: Tc99m-IDA scan, Hepatobiliary iminodiacetic acid [HIDA] scan, DHBS, Cholescintigraphy,
Hepatobiliary trauma, scintigraphy