Shih W J, Magoun S, Mills B J, Pulmano C
Nuclear Medicine Service, Veterans Affairs Medical Center, Lexington, KY 40511.
J Nucl Med. 1993 Jan;34(1):131-3.
Cholescintigraphy of a patient with bile leak demonstrated intra-abdominal activity that mimicked normal bowel activity. Because the gallbladder was not visualized, morphine was injected intravenously. Gallbladder activity after morphine injection was misleading in the finding of chronic cholecystitis. Concurrent abdominal sonography and computerized tomography revealed a thickened gallbladder wall with a gallstone and pericholecystic fluid collection. Exploratory laparotomy confirmed acute and chronic cholecystitis, cholelithiasis, choledocholithiasis, and a pericholecystic abscess. The false-negative conclusion for acute cholecystitis in the patient's morphine-augmented cholescintigraphy resulted from an acceleration of bile leakage due to pre-existing gallbladder perforation.
一位胆汁漏患者的胆管闪烁显像显示腹腔内有类似正常肠道活动的放射性。由于胆囊未显影，静脉注射了吗啡。注射吗啡后胆囊的放射性对慢性胆囊炎的诊断产生了误导。同时进行的腹部超声和计算机断层扫描显示胆囊壁增厚，伴有胆结石和胆囊周围液体积聚。剖腹探查证实为急性和慢性胆囊炎、胆石症、胆总管结石和胆囊周围脓肿。该患者经吗啡增强的胆管闪烁显像对急性胆囊炎得出假阴性结论，原因是既往存在的胆囊穿孔导致胆汁漏加速。
