Hepatobiliary scanning in hemobilia-induced acute cholecystitis

Radionuclide scanning of the hepatobiliary tree is highly accurate for the detection of patients with acute cholecystitis. Hemobilia, a rare complication of percutaneous liver biopsy, may result in blood clots within the biliary canaliculi. Such clots, like gallstones, may occlude the ducts and produce a clinical syndrome indistinguishable from acute cholecystitis. A patient with acute cholecystitis resulting from hemobilia following percutaneous biopsy of the liver is described. The diagnosis of acute cholecystitis secondary to blood clots was made with technetium 99mTc Iprofenin (Pipida [Sn]) scintigraphy. The patient was treated conservatively, and follow-up Pipida scan 6 weeks later demonstrated normal hepatobiliary function.