Hida Scan results

[chen60]

I had a HIDA SCAN in 6-07 and the fraction rate was 77% I have been sick since 10-07 with pain naseua vomitng and I have been in the ER 3 times,  I have had endoscopy,Upper GI with small bowel follow through, CT Scan bloodwork and everything is normal but I still have the symptoms.  The doctor order another HIDA SCAN and this time it came back at 40% does that mean it is the cause of my symptoms and I should have it out.  I meet with the surgeon in 2 days.

[CalGal]

They might 'catch' spasms on an MRCP, but they're not seen with an endoscopy. The problem with the spasms is they're often not seen. Non-invasively, they have to be inferred from your symptoms and from whether or not you respond to certain anti-spasm meds. They can sometimes be found when an ERCP with manometry is done, but that's an invasive test and it can have some serious post-testing problems associated with it. So it's not a test that should really be done usless it absolutely has to be done.

[chen60]

I do feel some tightness between my ribs sometimes, I have been waking up everynight around 2am and I try to go back to sleep I can feel it I thought I was having aniexty over being sick for so long but I wonder if it is the spasms?  I had an US and it was normal along with a CT scan with contract and that was normal.  I had and endoscopy would that had seen the SOD?

[chen60]

When the injected the CCK if felt sick and was very hot with pain in my stomach it lasted about 10 minutes. I am just afraid to have it out and then have the same symptoms after.

[CalGal]

No, the new reading does not mean you should get your GB out, all it means is that the first time the reading was done it was 'hyper.' The new level is within 'normal' range. But you should also check via ultrasound to find out whether you have stones or wall thickening of the gallbladder.

What could be going on are spasms of portions of the biliary system. Many people have them, but unfortunately they don't often seem to get diagnosed before GB surgery. Then when problems crop up after surgery, their presence seems to makes the whole of the condition much worse.

The condition that shows up after surgery is called SOD, sphincter of Oddi dysfunction and it's suggested to typically come from small stones that may be released during surgery (sludge) that irritate the common bile duct or the sphincter. But stones/crystals don't seem to have to be present to have this happen. A diagnosis of SOD is made via ERCP with manometry. If the ductal pressures are high, SOD is present.

Bring up the possibility of biliary spasms with your doc, and don't let him poo-poo them. They're very real.

[pacecar]

Hmm - good question.  I would get a second opin.  My son has been having some of the same problems.  We saw two surgeons and they both told us the same thing.  That the HIDA Scan is a bunch of hooey!   The only thing they wanted to know was did my son have pain at any time during the test.  Specifically when they injected the CCK.   BTW his HIDA results were 0%!   They also told us that if you have taken any type of narcotic pain meds 72 hours prior to the test - it could give you a false reading.   Hope this helps.  Best of Luck!