A 56 year old gentleman with upper abdominal pain and an ultrasound of the gallbladder that demonstrated a thickened wall with distension. Excretion into the duodenum excluded a complete common duct obstruction. No filling of the gallbladder was noted by 60 minutes.
Hepatobiliary scans are useful in determining the patency of the cystic duct.
An occluded cystic duct is the hallmark of acute cholecystitis. Recently, a morphine augmented study design has been introduced to shorten the overall study time. Non filling of the gallbladder 30 minutes after morphine injection confirms acute cholecystitis. Morphine augmentation is superior to delayed imaging.