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99mTc-HIDA dynamic scintigraphy for the diagnosis of gastroesophageal reflux of bile

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Abstract

In 5 patients with partial gastric resection and esophagitis, in whom esophageal pH metry was unable to demonstrate significant gastroesophageal reflux (GER), we administered i.v. 5 mCi (185 MBq) of 99mTc-HIDA, the patient lying under a computer-assisted LFOV gamma camera. When gallbladder image was evident, caerulein was administered i.v. at a physiologic dose in order to induce gallbladder contraction, and in the subsequent 45 min the patient was asked to perform a standard series of manoeuvres that increase the intraabdominal pressure (Valsalva, etc.) and favour GER. Scintigraphic images and time/activity curves obtained from areas of interest corresponding to gastric remnant and distal esophagus showed that at least one of these manoeuvres in each case was followed by the appearance of the radiocompound in the distal esophagus, indicating a 99mTc-HIDA-tagged bile GER. Consequently, we believe that HIDA-GER dynamic scintigraphy may be more useful than esophageal pH metry in demonstrating the biliary origin of an esophagitis.

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References

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Correspondence to Dr. M. Bortolotti.

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Bortolotti, M., Abbati, A., Turba, E. et al. 99mTc-HIDA dynamic scintigraphy for the diagnosis of gastroesophageal reflux of bile. Eur J Nucl Med 10, 549–550 (1985). https://doi.org/10.1007/BF00252750

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Key words

  • Bile reflux
  • HIDA 99mTc hepatobiliary scintigraphy
  • Gastroesophageal reflux