Meperidine in conjunction with cholescintigraphy to diagnose acute cholecystitis in a patient allergic to morphine

Cholescintigraphy with morphine augmentation is used routinely to expedite the differential diagnosis of acute from chronic cholecystitis. A patient with hepatic dysfunction and an allergy to morphine received intravenous meperidine in conjunction with cholescintigraphy. The gallbladder was not visualized 30 minutes after administration of the drug. However, the activity accumulated in the initial photon deficient gallbladder at 4 hours after meperidine administration (6.5 hours after radiopharmaceutical administration). These findings may be explained in part by prolongation of meperidine bioavailability because of impairment of hepatic function.