ARRS 2022 Abstracts

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E2073. Evaluating Right Upper Quadrant Pain With HIDA Scan: Case-Based Multimodality Pictorial Review
Authors
  1. Mohammed Alagha; Rush University Medical center
  2. Pokhraj Suthar; Rush University Medical center
  3. Sumeet Virmani; Rush University Medical center
Background
Hepatobiliary scintigraphy with 99mTc-labeled iminodiacetic acid analogs (HIDA scan) is a common imaging test for evaluation of hepatic and biliary diseases, with the most common indications being evaluation of acute or chronic cholecystitis and biliary leak. The test has the highest sensitivity and specificity for evaluating acute cholecystitis. This case-based pictorial review focuses on the spectrum of characteristic imaging findings on HIDA scans to evaluate patients with right upper quadrant pain, with multimodality correlation when available.

Educational Goals / Teaching Points
Interesting cases with a spectrum of characteristic imaging findings highlighting the importance of a HIDA scan in evaluation of patients with right upper quadrant pain are presented in this case-based pictorial review. Multimodality correlative imaging is provided where available.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this exhibit, we present 15 interesting cases with multimodality correlation that highlight the importance of HIDA scan with characteristic findings in patients with right upper quadrant pain. We include acute and chronic cholecystitis, biliary dyskinesia, biliary leak, bilioma, hepatocellular disease, hepatic metastases, hepatic cyst, choledochal cyst, FNH, sphincter of Oddi spasm, enterogastric reflux, rim sign, nubbin signed, CBD obstruction (liver spleen sign), biliary atresia, neonatal jaundice, and afferent loop syndrome.

Conclusion
HIDA scans play an important role in the diagnosis and management of patients with right upper quadrant pain. Knowledge of imaging findings will lead to earlier treatment and reduced morbidity and mortality.