Incidentally Detected Intestinal Malrotation on Hepatobiliary Scan in a Patient With Bile Duct Injury

Abstract

A 56-year-old woman had bilious discharge 48 hours after laparoscopic cholecystectomy because of acute cholecystitis. Tc-99m DISIDA hepatobiliary scan showed proximal intestinal loops of the duodenum and jejunum in the right abdomen and a biliary leakage from the gallbladder bed to the drainage tube. It also showed a photopenic space-occupying lesion at the inferior tip of the right hepatic lobe that was diagnosed as a simple cyst at the time of the laparoscopic procedure. Exploratory laparotomy showed bile leakage from the right hepatic biliary duct and intestinal malrotation.