Serendipity in technetium-99m dimethyl iminodiacetic acid cholescintigraphy. Diagnosis of nonbiliary disorders in suspected acute cholecystitis

Technetium-99m dimethyl iminodiacetic acid cholescintigraphy has contributed significantly to the diagnosis of acute and chronic biliary tract disorders. Yet attention should also be focused on the other structures visualized during the blood pool, hepatocyte, renal excretory, and intestinal phases of the study. Nonbiliary pathology was detected in 42 of 294 patients (14.3%) studied for suspected acute cholecystitis. The serendipitous detection of previously unsuspected abnormalities assisted in directing further work-up away from suspected biliary disease and towards the real source of the patient's acute problem in 28 cases (9.5%).