Diagnostic ability of hepatobiliary scintigraphy

Morphological aspects of biliary images were observed by the hepatobiliary scintigraphy using 99mTc-PI (pyridoxylidene isoleucine). Our study was made mainly on the diagnostic ability of the scintigram in various hepatobiliary diseases. Diagnostic findings were observed in 53.8% of the cases with intrahepatic stones and all cases with cholangioma. In the stone of the common bile duct and extrahepatic biliary cancer, the diagnostic findings were observed in 42.3% and 37.5% respectively. Hepatobiliary scintigraphy was less reliable for the diagnosis of the lesions in the gallbladder. The findings by hepatobiliary scintigraphy were as same as those by X-ray basically. In the cases showing the diagnostic finding by hepatobiliary scintigraphy, it seems to be possible to distinguish the stone from the cancer. Contrary to X-ray picture, scintigram is inferior in the image. So, it is necessary to perform ERCP or PTC to investigate fully the hepatobiliary lesions.

Diagnosis of pancreatic cancer by endoscopic retrograde cholangiopancreatography and pancreozymin secretin test

Eighy cases with carcinoma of the pancreas were divided into 10 groups according to the location and size of the tumor. Drip infusion cholangiography, percutaneous transphepatic cholangiography, hypotonic duodenography and endoscopic retrograde cholangiopancreatography were employed for this classification. Comparison of cholangiopancreatograms (ERCP) with results of the biliary and pancreatic secretory function assessed by pancreozymin secretin test (PS test clarifies secretory capacity of the exocrine pancreas. But combination of ERCP and PS test with cytology is necessary for the correct diagnosis of the pancreatic cancer and it is hoped that the combination may excavate the disease in the early stage.

A bleeding Meckel's diverticulum diagnosed by arteriography

A case of Meckel's bleeding diverticulum diagnosed by emergent arteriography is presented. Arteriography revealed an extravasation of contrast medium into the distal ileum and an abnormal ileal artery which passed to the antimesenteric border of the ileum. The diverticulum was demonstrated by double contrast study of the small intestine. The merits of emergent arteriography and other examinations for diagnosing Meckel's diverticulum are discussed.