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Cholescintigraphy in the critically ill.

W L Garner1, M V Marx, P J Fabri

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

American Journal of Surgery
|June 1, 1988
PubMed
Summary
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Cholescintigraphy is unreliable for diagnosing acute cholecystitis in critically ill patients. Common conditions in these patients, like cholestasis, reduce the test's accuracy, making diagnosis challenging.

Area of Science:

  • Hepatobiliary Imaging
  • Critical Care Medicine
  • Diagnostic Accuracy Studies

Background:

  • Acute cholecystitis diagnosis is challenging in critically ill patients.
  • Cholescintigraphy (HIDA scan) is a common diagnostic tool.
  • Critically ill patients often have confounding factors affecting imaging.

Purpose of the Study:

  • To critically review the diagnostic utility of cholescintigraphy for acute cholecystitis in critically ill patients.
  • To assess the accuracy of cholescintigraphy in this specific patient population.

Main Methods:

  • Review of 17 cholescintigraphy scans in critically ill patients with suspected acute cholecystitis.
  • Analysis of true-negative, false-negative, false-positive, and non-diagnostic scan results.

Related Experiment Videos

  • Correlation with clinical evidence of acute cholecystitis.

    • Main Results:

    • Only 7 of 17 scans were true-negative.
    • 1 scan was false-negative, and 6 were false-positive.
    • 3 scans were nondiagnostic, indicating low utility.
    • Abnormal clearance of imaging agents due to cholestasis and hepatocyte dysfunction was observed.

    Conclusions:

    • Cholescintigraphy is not a conclusive diagnostic tool for acute cholecystitis in critically ill patients.
    • Cholestasis and hepatocyte dysfunction significantly impair the accuracy of hepatobiliary radionuclide imaging.
    • Diagnosing acute cholecystitis in the critically ill remains a significant clinical challenge.