What is a gastric emptying scan? The scan measures the time it takes for solid food and to pass through the stomach.
When should I order a gastric emptying scan? 1. Patients with upper gastrointestinal symptoms not related to reflux
or peptic ulcer disease.
2. Diabetic patients with upper GI symptoms
What do I tell my patient?
Allow 4 hours.
The patient will need to fast overnight as the scan is usually performed in the morning. The patient will be given a standard meal of two labelled scrambled eggs, toast and water. The patient will then have a one minute image taken of the radiolabelled food in her/his stomach. This image will be repeated 5 times over the next four hours.
What will the scan tell me ?
The passage of radiolabelled food through the stomach will be displayed and the clearance rate will be calculated. The report will indicate if the passage of food through the stomach is normal or not.
What next?
In patients with marked gastroparesis, review by a gastrointestinal specialist is usually indicated.
What is a hepatobiliary scan?
The scan assess the function of the gall bladder and biliary tree and is often used to detect acute and chronic cholecystitis.
When should I order a hepatobiliary scan? 1. Patients suspected of acute cholecystitis.
2. Patients suspected of chronic cholecystitis.
3. Patients suspected of common bile duct obstruction
What do I tell my patient?
Allow 3 hours.
The patient will need to fast for 4 hrs before scanning.
The patient will receive an intravenous injection of a tracer and will be scanned for 30-60 minutes. The tracer behaves like bilirubin and is taken up and excreted by the liver. Depending on the initial images and the clinical conditions, it may be necessary to administer intravenous CCK or morphine and image for an additional 30 minutes to adequately assess gallbladder function.
What will the scan tell me? The scan will either confirm or exclude acute cholecystitis with an accuracy of over 95%. If the clinical question is gallbladder dysfunction, the reaction of the gallbladder to CCK is expressed as the gallbladder ejection fraction. If the scan is normal, gallbladder dysfunction is excluded.
Normal Hepatobiliary scan
A normal Hepatobiliary scan in a 34 year old women suspected of acute cholecystitis. There is prompt uptake of tracer by the liver with progressive accumulation of tracer in the gallbladder excluding acute cholecystitis as a cause of this patients pain.
What next? Positive scans demonstrating acute or chronic cholecystitis usually require a surgical consultation with the urgency being related to the patient’s condition.
