Hepatobiliary scintigraphy in a patient with bilhemia

Didier François, Stéphan Walrand, Jean Paul Van Nieuwenhuyse, Jean de Ville de Goyet, Stanislas Pauwels

Research output: Contribution to journalArticle

Abstract

A 4-year-old child referred for acute jaundice following percutaneous needle biopsy of the liver underwent hepatobiliary scintigraphy. Although all conventional liver tests suggested preservation of hepatocyte function, the tracer uptake in the liver appeared dramatically reduced at scintigraphy and the blood pool activity did not decrease significantly until the end of the study. Visualization of the bile ducts indicated, however, that the tracer was taken up by the hepatocyte and further excreted into the biliary tree. There was no tracer pooling in the biliary tree although no bowel activity was observed, even on delayed images. The association of persistent blood pool activity, bile duct visualization without tracer pooling, and nonvisualization of the bowel was caused by a continuous recirculation of the tracer from the biliary tree into the bloodstream. The presence of a biliovenous fistula was further proven by percutaneous transhepatic cholangiography performed 24 h later. Since 1975, only 16 cases of bilhemia have been reported. To the best of our knowledge the scintigraphic pattern of this rare but lifethreatening complication has not previously been reported.

Original languageEnglish
Pages (from-to)1020-1023
Number of pages4
JournalEuropean Journal Of Nuclear Medicine
Volume21
Issue number9
DOIs
Publication statusPublished - Sep 1994

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Keywords

  • Bilhemia
  • Hepatobiliary scintigraphy
  • Jaundice
  • liver trauma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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