Extended application of 99mTc-mebrofenin cholescintigraphy with cholecystokinin in the evaluation of abdominal pain of hepatobiliary and gastrointestinal origin

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Abstract
Objective To explore the extension of cholecystokinin-cholescintigraphy in the evaluation of abdominal pain. Methods A total of 1554 patients with abdominal pain underwent 99mTc-mebrofinin cholescintigraphy. Gallbladder ejection fraction was obtained with cholecystokinin (sincalide) and abdominal pain was graded. Results Fourteen different types of hepatobiliary and gastrointestinal motility disorders were identified. Biliary dyskinesia was found in 453 patients, septate gallbladder in 33, and duodeno-gastric bile reflux in 46 patients. Sincalide-induced intestinal hyperperistalsis alone was found in 65 and in combination with other diseases in 64 patients. Abdominal pain was mild to moderate in intensity, and occurred in 50–60% of patients with abnormal gallbladder function. Severe abdominal pain was usually associated with intestinal hyperperistalsis. Conclusion 99mTc-mebrofinin cholescintigraphy enables the identification of motility disorders of the gastrointestinal and hepatobiliary tract, and post-sincalide abdominal pain in most cases can be assigned to functional abnormality of the gallbladder or/and intestine.