RESUMO
The patient is a 44-year-old woman with Crohn's disease, who presented to the ED with abdominal pain. Initial imaging by CT and US showed mild biliary tree dilatation, mild gallbladder distension, and pericholecystic fluid. The cystic and common bile ducts were patent without bile leak on cholescintigraphy. The next day, MRCP revealed free fluid extending from the gallbladder fossa to the right lower quadrant. Subsequently, a repeat cholescintigraphy was performed which was positive for bile leak. This case highlights the use of multiple imaging modalities in assessing abdominal pain, pre-and post-biliary leak.
Assuntos
Doenças Biliares/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Compostos de Anilina , Feminino , Glicina , Humanos , Iminoácidos , Imagem Multimodal , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios XRESUMO
We present a case of a 70-year-old male who was referred for a technetium-99m methylene-diphosphonate bone scan for mild left hip pain and an elevated alkaline phosphatase level of 770 units/L. No additional information was provided and the patient's history was limited due to a language barrier. We were able to ascertain that the patient had a remote history of prostate cancer, which had been treated with radiation. Originally, we felt the bone scan was compatible with Paget's disease; however, further work-up revealed the presence of osteosarcoma, which was potentially radiation-induced.