A False Negative Non-Morphine-Augmented Hepatobiliary Scan in a Patient with Empyematous Calculous Cholecystitis

Received 11/9/2004; revised 12/15/2004; accepted 12/17/2004. For correspondence or reprints contact: Shih-Chuan Tsai, M.D., Department of Nuclear Medicine, Show-Chwan Memorial Hospital, 542 Section 1, Chung-Shang Road, Changhua 500, Taiwan, ROC. Tel: (886)4-7256166 ext. 6322, Fax: (886)4-7117466. False-negative results of hepatobiliary scans for the diagnosis of acute calculous cholecystitis are rare. We report a 60-year-old male case in which the diagnosis was suggested by typical clinical presentation (RUQ pain, fever and leukocytosis) and abdominal sonography (distension and mild thickened wall of the gallbladder with gallbladder stone), but a false negative TcDISIDA non-morphine-augmented hepatobiliary scan (visualization of the gall bladder since the 30 min imaging). The final diagnosis was empyematous calculous cholecystitis. This case report concludes that caution has to be taken in interpreting hepatobiliary scans, although the false-negative rate is very low.