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Morphine cholescintigraphy.

L Flancbaum¹, S M Alden

¹Department of Surgery, Ohio State University, College of Medicine, Columbus 43210.

Surgery, Gynecology & Obstetrics

|September 1, 1990

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Morphine sulfate administration improves gallbladder visualization during radionuclide cholescintigraphy (RC) in critically ill patients. This enhancement increases the accuracy of diagnosing acute cholecystitis, especially when initial scans are non-diagnostic.

Area of Science:

Hepatobiliary Imaging
Diagnostic Nuclear Medicine

Background:

Radionuclide cholescintigraphy (RC) is vital for diagnosing acute cholecystitis.
Nonvisualization of the gallbladder in RC can occur in critically ill patients due to factors like fasting or critical illness, leading to false positives.

Purpose of the Study:

To evaluate the efficacy of morphine sulfate in improving gallbladder visualization during RC.
To enhance the diagnostic accuracy of RC in patients with suspected biliary sepsis and non-visualization.

Main Methods:

Morphine sulfate (0.05-0.1 mg/kg IV) was administered to 68 patients with non-visualizing gallbladders on initial RC.
Gallbladder visualization post-morphine administration was assessed within 60 minutes.

Main Results:

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Gallbladder visualization occurred in 38 patients after morphine sulfate administration.
The procedure aided in excluding acute cholecystitis in 37 patients.
Overall accuracy was 96%, with 97% sensitivity and 95% specificity.

Conclusions:

Morphine sulfate administration significantly enhances gallbladder visualization in RC.
This adjunctive method improves the reliability of RC for diagnosing acute cholecystitis, particularly in critically ill patients.