Indian Journal of Nuclear Medicine
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CASE REPORT
Year : 2017  |  Volume : 32  |  Issue : 1  |  Page : 36-38

Dumbbell gallbladder cholecystitis on tc-99m diisopropyliminodiacetic acid hepatobiliary imaging


1 Department of Nuclear Medicine and Molecular Imaging, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
2 Department of Biological Sciences, New Jersey Institute of Technology, New Jersey, USA

Correspondence Address:
Asif Ali Fakhri
Department of Nuclear Medicine and Molecular Imaging, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 105 Parker Hall, 3435, Main Street, Buffalo, New York
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.198474

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We present a case of a 79-year-old immunocompromised female admitted for abdominal pain and sepsis, who had an abdominal computed tomography (CT) showing distal gallbladder fundus wall thickening, pericholecystic edema, and a right posteroinferior hepatic abscess. Subsequent hepatobiliary scintigraphy with Tc-99m diisopropyliminodiacetic acid showed gallbladder filling of the proximal gallbladder fundus, yet no radiotracer filling of the distal gallbladder fundus. Further correlation with the initial CT showed a partial gallbladder stricture and a resultant altered morphology resembling a dumbbell-shaped gallbladder. Percutaneous cholangiogram also confirmed this dumbbell morphology. Nonfilling of radiotracer into the distal end of the dumbbell gallbladder correlating with CT findings of focal gallbladder inflammation indicated that there was a focal inflammation suggesting a distal dumbbell gallbladder cholecystitis. This case demonstrates a unique finding of focal inflammatory pathology involving an anatomic variant - the dumbbell-shaped gallbladder, and the challenges this anatomic variant presents in hepatobiliary scintigraphy image interpretation.


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