Case Author(s): Tate Allen, M.D. and Tom R. Miller, M.D., Ph.D. , 9/11/98 . Rating: #D2, #Q4

Diagnosis: Biliary Leak

Brief history:

Abdominal pain in a liver transplant patient


Hepatobiliary Scintigraphy

View main image(hs) in a separate image viewer

View second image(fl). ERCP

Full history/Diagnosis is available below

Diagnosis: Biliary Leak

Full history:

This is a 51 year-old man who underwent liver transplantation for hepatitis C three months ago. The pateint's T-tube was removed one day prior to this examination. After the tube was removed, the patient has had worsening abdominal pain.


3.3 mCi Tc-99m mebrofenin i.v.


The hepatobiliary study shows leakage of tracer at the choledochocholedochostomy into the gallbladder fossa, right sub-hepatic space, and the right pericolic gutter. An ERCP was performed after this study. It showed contrast exiting the common bile duct through the T-tube tract (small white arrows) and pooling in the abdominal wall of the patient (large white arrow). At fluroscopy, contrast was also identified flowing into the paritoneal cavity.


Also see cases hs006, hs 009, and hs011.


A stent was placed in the bile duct crossing the surgical anastomosis.

View followup image(fl). Stent across the bile duct

ACR Codes and Keywords:

References and General Discussion of Hepatobiliary Scintigraphy (Anatomic field:Gasterointestinal System, Category:Inflammation,Infection)

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Case number: hs014

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