Sonographic and scintigraphic detection of a bile leak in a post-cholecystectomy patient. Recognition of the tail sign.

Hepatobiliary scintigraphy using Tc-99m HIDA derivates is used primarily for the diagnosis of acute cholecystitis and for demonstration of biliary tract patency. Ultrasound is usually employed for diagnosing cholelithiasis and biliary tree dilatation, as well as identifying focal lesions in the liver. These two complementary modalities are also useful in the evaluation of post-cholecystectomy patients. We present a case of a bile leak, diagnosed by these two modalities.