Apparent gut excretion of Tc-99m-DISIDA in a case of extrahepatic biliary atresia

Our patient had DISIDA scan at 39 days of age to exclude biliary atresia. Gut excretion was seen 18 h after injection and the diagnosis of neonatal hepatitis was made. Because of continued elevated liver function values, liver biopsy was performed and demonstrated findings consistent with biliary atresia. Exploratory laparotomy performed 8 days after the scan showed patent cystic duct, bile duct, and gallbladder, but an atretic common hepatic duct. This case is an example of documented biliary atresia demonstrating gut excretion on the DISIDA scan.