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Unique Scintigraphic Findings of Bile Extravasation in the Presence of Ascites: A Complication of Hepatic Transplantation

Departments of Radiology, Nuclear Medicine, and Department of Radiology, Pediatrics, University of California Medical Center, San Francisco, California

Correspondence: For reprints contact: E. Dayan Sandler, MD, Chief Resident Nuclear Medicine, Department of Radiology, University of California, San Francisco, CA 94143-0628.

ABSTRACT

A ^99mTc-HIDA scan was performed on a 4-mo-old female, six days after hepatic transplantation. Gradually, a diffuse increase in activity was seen over the peritoneal region, consistent with a slow bile leak into ascitic fluid. Although the scintigraphic appearance of a bile leak has been previously described, it is usually seen as a focal area of extrabiliary activity. In this case, we report a pattern identified when the leak occurs in conjunction with ascites.