Hepatobiliary scanning in hemobilia-induced acute cholecystitis

Abstract

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.

Acute Cholecystitis Secondary to Hemobilia after Percutaneous Liver Biopsy

“…The number of passes varied from 1 to 3 in the 4 cases reported in the literature [6, 7, 8, 9]. In the present case, it was performed in 2 passes.…”

“…Only few cases of acute cholecystitis secondary to percutaneous liver biopsy have been reported [6, 7, 8, 9, 10, 11]. The number of passes varied from 1 to 3 in the 4 cases reported in the literature [6, 7, 8, 9].…”

“…These complications include bleeding into the peritoneal or thoracic cavity, hemobilia, enteric perforation, and intrahepatic hematoma [3, 4, 5]. Only few cases of acute cholecystitis have been described after liver biopsy [6, 7, 8, 9, 10, 11]. Our objective is to report the case of a patient who developed acute cholecystitis secondary to percutaneous liver biopsy.…”

Secondary hemocholecyst after radiofrequency ablation therapy for hepatocellular carcinoma

“…However, rarely, transcatheter injection of urokinase into the gallbladder has produced remission in patients who were not surgical candidates. 16,29 Nevertheless, once the clot in the gallbladder begins to organize, it is very unlikely to dissolve, and cholecystectomy is the treatment of choice. When hemobilia and HC persist, we believe that concomitant cholecystectomy and transcatheter arterial embolization are indicated.…”