Abnormal 99mTc-PIPIDA scans mistaken for common duct obstruction.

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Abstract
99mTc-PIPIDA (iprotenin) scans were obtained in 3 patients with acute abdominal pain. The appearance of the scans suggested partial common duct obstruction. Two patients underwent surgery. One had acute appendicitis and the second had infarction of the distal ileum. In both cases, the gallbladder and biliary tract were normal. The 3rd patient had been treated with morphine, which is known to increase biliary tract pressure and may cause contraction of the sphincter of Oddi. An ultrasound study of the gallbladder was normal and all symptoms resolved within 24 h. Three additional patients without biliary disease were seen who had similar hepatobiliary scans. All 3 had received meperidine prior to the study. Acute abdominal disease or the administration of morphine sulfate or meperidine can result in a scan pattern suggesting partial distal common duct obstruction in the absence of gallbladder or biliary tract disease.