Endotoxic shock and its effects on hepatobiliary scanning in dogs

Hepatobiliary scans were obtained with Tc-99m-disofenin in 15 dogs. Of these, 5 served as controls, 5 were infused with E. coli endotoxin for 4 hours (endotoxic shock group), and 5 were bled to a mean pressure similar to that of the endotoxic shock group (hemorrhagic shock group). Scans of the controls and hemorrhagic shock group were identical. Scans of the endotoxic shock group were markedly abnormal, with a prolonged hepatic phase and little excretion of isotope into the biliary tract, a pattern characteristic of mechanical obstruction of the common bile duct. These results should alert the clinician to the potential danger of abnormal hepatobiliary scans in the septic patient.