Morphine-augmented cholescintigraphy enhances duodenogastric reflux

Area of Science:

• Hepatobiliary imaging
• Gastroenterology
• Diagnostic radiology

Background:

• Cholescintigraphy is a key diagnostic tool for acute cholecystitis.
• Duodenogastric reflux is a potential complication observed during scintigraphy.
• Morphine administration is used to expedite gallbladder visualization.

Purpose of the Study:

• To evaluate the occurrence of duodenogastric reflux during cholescintigraphy with and without morphine intervention.
• To compare the incidence and severity of duodenogastric reflux in patients with acute versus chronic cholecystitis undergoing morphine-augmented cholescintigraphy.

Main Methods:

• Retrospective review of 55 patients undergoing cholescintigraphy.
• Comparison between patients who received morphine intervention (32) and those who did not (23).
• Duodenogastric reflux identified visually based on activity patterns adjacent to the left hepatic lobe.

Main Results:

• Duodenogastric reflux occurred in 53% of patients with morphine intervention versus 9% without (p < 0.001).
• In the morphine group, reflux was observed in 58% of acute cholecystitis cases and 46% of chronic cholecystitis cases.
• The severity of duodenogastric reflux was greater in patients with acute cholecystitis compared to chronic cholecystitis.

Conclusions:

• Cholescintigraphy with morphine significantly enhances the occurrence of duodenogastric reflux.
• The incidence of duodenogastric reflux is not significantly different between acute and chronic cholecystitis when morphine is used.
• Morphine-augmented cholescintigraphy increases the likelihood and severity of duodenogastric reflux, particularly in acute cholecystitis.