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A crying liver: a scan pattern mimicking spontaneous perforation of the biliary ducts
, 1, 1, 1, 2, 1
Affiliations- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Pediatric Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
open access
Abstract
A 2-month-old infant was referred for hepatobiliary scintigraphy due to ascites of unknown cause. The top differential diagnosis was spontaneous perforation of the biliary ducts. Delayed images up to 4 hours were against this diagnosis showing normal distribution of the radiotracer throughout the bowel. However, on delayed images, the scan showed mild tracer retention in the ascites confirmed by SPECT/CT images. Surprisingly, the exploratory abdominal surgery revealed an intact hepatobiliary system, pointing toward other possible etiologies. Second-review surgery was performed due to uncontrolled progressive ascites showing congestive hepatopathy and biliary leak from the hepatic surface suggestive of the “crying liver”.
Abstract
A 2-month-old infant was referred for hepatobiliary scintigraphy due to ascites of unknown cause. The top differential diagnosis was spontaneous perforation of the biliary ducts. Delayed images up to 4 hours were against this diagnosis showing normal distribution of the radiotracer throughout the bowel. However, on delayed images, the scan showed mild tracer retention in the ascites confirmed by SPECT/CT images. Surprisingly, the exploratory abdominal surgery revealed an intact hepatobiliary system, pointing toward other possible etiologies. Second-review surgery was performed due to uncontrolled progressive ascites showing congestive hepatopathy and biliary leak from the hepatic surface suggestive of the “crying liver”.
Keywords
hepatobiliary scintigraphy; crying liver; biliary leak
About this articleTitle
A crying liver: a scan pattern mimicking spontaneous perforation of the biliary ducts
Journal
Issue
Article type
Clinical vignette
Pages
131-133
Published online
2022-06-22
Page views
4096
Article views/downloads
313
DOI
Pubmed
Bibliographic record
Nucl. Med. Rev 2022;25(2):131-133.
Keywords
hepatobiliary scintigraphy
crying liver
biliary leak
Authors
Somaye Barashki
Hadis Mohammadzadeh Kosari
Emran Askari
Zahra Bakhshi Golestani
Mehran Hiradfar
Ramin Sadeghi
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