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PTH-033 Detection of duodeno-gastric reflux during routine 99mTc-hida scintigraphy
  1. L I Sonoda1,
  2. M Y Halim1,
  3. S Middleton2,
  4. K K Balan1
  1. 1Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK
  2. 2Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK

Abstract

Introduction Duodeno-gastric reflux (DGR) is an incidental finding on 99mTc-HIDA studies but its detection often yields useful clinical information. Present study was carried out to determine the rate of detection as well as incidence of DGR in patients undergoing routine HIDA imaging over a 5-year-period.

Methods One hundred and eighty-three sequential patients (52 males, 131 females, mean age 46 years old) who underwent 99mTc-HIDA cholescintigraphy over a 5-year-period between 2004 and 2008 have been retrospectively reviewed. Age, sex, previous surgery, clinical indications for the study, presence or not of DGR and clinical reports were subjected to analysis.

Results Biliary dyskinesia (n=135; 74%), post-surgical symptoms (n=33; 18%) and sphincter of Oddi dysfunction (n=15; 8%) were the main indications for the study. 33/183 (18%) patients had DGR of which 21 (64%) were present in 117 patients with otherwise normal studies while 12 (36%) were seen in 66 patients with abnormal results (p=0.87). All except one case of DGR was detected and mentioned in the original clinical report. 25/132 (19%) and 8/51(18%) patients, respectively, with normal and abnormal biliary tract anatomy were found to have DGR (p=0.76). Occurrence of DGR had no significant relationship with age, sex or gall bladder ejection fraction.

Conclusion DGR is an easily detected common finding on routine cholescintigraphy and may be the cause of presenting symptoms in patients who may have an otherwise normal HIDA study. The occurrence of DGR does not appear to have any significant relationship with age and sex of patients, biliary tract anatomy, or gall bladder function.

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