Cholescintigraphy in acute cholecystitis: use of intravenous morphine.

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Abstract
Conventional cholescintigraphy (60 patients) and a modified protocol (59 patients) were compared in 74 females and 45 males with acute cholecystitis. In the modified protocol, i.v. morphine (0.04 mg/kg) was administered whenever the gallbladder was not seen 40 min after injection of 99mTc-pyridoxylideneglutamate (36/59). Accuracy was 98% with morphine, compared with 88% for the conventional protocol; specificity improved from 83 to 100% with no loss of sensitivity (96% in both groups). Low doses of morphine are well tolerated and can result in a highly accurate diagnosis of acute cholecystitis without the need for delayed imaging.

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