Affordable Access

Prompt visualization of the gallbladder with a rim sign--acute or subacute cholecystitis?

Authors
  • Morrison, J C
  • Ramos-Gabatin, A
  • Gelormini, R G
  • Brown, J W
  • Pitts, N L
Type
Published Article
Journal
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Publication Date
Jul 01, 1993
Volume
34
Issue
7
Pages
1169–1171
Identifiers
PMID: 8315497
Source
Medline
License
Unknown

Abstract

An immunosuppressed, neutropenic patient developed symptoms and signs of acute cholecystitis. Gallbladder ultrasound was consistent with acute cholecystitis. Technetium-99m-diisopropyl iminodiacetic acid (DISIDA) scan showed a rim sign, but with normal gallbladder visualization. On restudy 72 hr later when the patient's WBC count was recovering, the 99mTc-DISIDA scan again showed a persistent rim sign, but now there was no gallbladder visualization at 1 hr, a pattern strongly predictive for acute complicated cholecystitis. Biliary drainage was performed by percutaneous cholecystotomy with clinical improvement. Semielective cholecystectomy performed 8 wk later confirmed both acute and chronic cholecystitis. We describe the rim sign and its variants, mechanisms of causation, prognostic importance and correlate our report with a review of the literature.

Report this publication

Statistics

Seen <100 times