Biliary leak in a child after liver transplant and value of delayed images
Nina Mortazavi1, Philippe Chaumet-Riffaud, Philippe Chauffet-Riffaud
1Service de Biophysique et Médecine Nucléaire, AP-HP, Bicêtre & Univ Paris-Sud, Le Kremelin Bicêtre Cedex, France. mortazavi.nina@gmail.com
Insights
Hepatobiliary scintigraphy using Tc-99m iminodiacetic acid (IDA) aided in diagnosing a biliary leak post-liver transplant in a pediatric patient. Delayed imaging proved crucial for confirming the leak at the anastomosis site.
Area of Science:
- Pediatric surgery
- Diagnostic imaging
- Hepatobiliary medicine
Background:
- Liver transplantation is a complex procedure with potential complications.
- Post-surgical abdominal pain in pediatric liver transplant recipients requires accurate diagnosis.
- Hepatobiliary scintigraphy with Tc-99m iminodiacetic acid (IDA) is a noninvasive imaging modality.
Observation:
- A 2-year-old child presented with abdominal pain after liver transplant.
- Hepatobiliary scintigraphy was performed to investigate the cause of pain.
- Delayed imaging (24-hour) was utilized as part of the scintigraphic protocol.
Findings:
- The hepatobiliary scintigraphy successfully identified a biliary leak.
- The leak was precisely located at the site of anastomosis.
- The use of delayed images was instrumental in reaching the diagnosis.
Implications:
- This case highlights the diagnostic value of delayed Tc-99m IDA scintigraphy in pediatric liver transplant patients.
- The noninvasive nature of this imaging technique is particularly beneficial for children.
- Delayed imaging can resolve equivocal findings and confirm biliary leaks effectively.
Abstract:
A 2-year-old child underwent liver transplant and was referred for postsurgical abdominal pain. Hepatobiliary scintigraphy with Tc-99m iminodiacetic acid (IDA) was performed and with the help of 24-hour delayed images, the diagnosis of biliary leak at the site of anastomosis was made possible. This case report confirms the value of delayed images to facilitate the diagnosis in unequivocal situations and reminds us of the usefulness of this noninvasive method, especially in pediatrics.