Scintigraphic detection of segmental bile-duct obstruction

In a patient with acute obstructive jaundice, cholescintigraphy with technetium-99m-labeled iminodiacetic acid (HIDA) showed uniformly reduced uptake in the left lobe of the liver. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated cholelithiasis and obstruction of the distal hepatic duct. Surgery, and later a T-tube cholangiogram, confirmed the presence of numerous stones in the left intrahepatic and common hepatic ducts. The liver was free of tumor. Intrahepatic segmental ductal obstruction may produce a spectrum of patterns on hepatobiliary imaging ranging from reduced uptake to intrahepatic pooling.