BILISCINTIGRAPHY VERSUS ULTRASONOGRAPHY I N THE ETIOLOGIC DIAGNOSIS OF ACUTE-PANCREATITIS

Etiology of acute pancreatitis has important implications in the treat ment of the disease as gallstones pancreatitis requires the correction of the underlying biliary disease. The usefulness of ultrasonography in the detection of stones in emergency has been questioned, and HIDA biliscintigraphy has been reported to be a possible indicator of bilia ry pancreatitis. This study compares the value of HIDA colesscintigrap hy and ultrasonography in the etiologic diagnosis of OK patients admit ted and treated for acute pancreatitis in our Institution. All patient s underwent ERCP for the confirmation of the findings. Cholescintigrap hy showed no visualisation of the gallbladder, suggesting biliary trac t stones, in 25 patients. In all of them ERCP confirmed the presence o f gallbladder and/or common bile duct stones, and endoscopic sphincter otomy and later elective cholescystectomy was performed. Ultrasonograp hy failed to demonstrate biliary stones in 11 of those patients. HIDA cholescintigraphy showed a sensitivity and a negative predictive value of 1 vs 0.56 and 0.45 for ultrasonography. From the results of our st udy it can be conclueded that HIDA biliscintigraphy is more reliable t han ultrasonography in the discrimination of biliary vs non-biliary ac ute pancreatitis in emergency.