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Forum Name: Gastroenterology Topics

Question: Is CCK necessary with HIDA to diagnose gallbladder?


 pjl53 - Thu Sep 10, 2009 10:10 pm

Is it possible to tell enough from the HIDA without the CCK to determine whether there is enough of a problem that removal is necessary? I also need to know whether CCK contains any preservatives.

I have a long history of gallbladder symptoms. I also have Sjogren's and other autoimmune diseases, along with many, many allergies to drugs and preservatives. I've had a CT scan and ultrasound. Now, the doctor recommends a HIDA with CCK. I'm already in considerable pain and live alone. There's no one to help me if the CCK sets off a severe attack or days of diarrea. It isn't common for that to happen or to have an allergic reaction. I know that. However, it does happen. My system is extremely sensitive because of the autoimmune disorders and allergies, and it is a synthetic hormone. It's a guessing game every time. Needless to say, I'm not anxious for surgery either. A UTI required a PIC line and an infectious disease specialist to treat me because of the limited antibiotics I tolerate. Thanks for your help.
 Dr.M.Aroon kamath - Fri Nov 27, 2009 8:16 pm

User avatar Hi,
Ultrasonography is the most common test used in the diagnosis of biliary colic and acute cholecystitis. It's sensitivity is 90-95% for cholecystitis and specificity is
78-80%. It is 98% sensitive and specific for simple cholelithiasis.

CCK(cholecystokinin) is not mandatory for diagnosing gall bladder problems in each and every case.

There are a few advantages of cholescintigraphy over Ultrasonography, such as...
- Assessment of gall bladder function and its ability to quantify it.
- 'Normal-appearing' gallbladder (by ultrasound) with obstructed cystic duct.This situation may show up on cholescintigraphy but not on ultrasound.

Its chief usefulness lies in its ability in diagnosing 'biliary dyskinesia' (gall bladder dysmotility).
I understand your genuine concerns due to your past medical background.It is possible that your ultrasonogram was inconclusive.Please remember that if a person in your kind of situation (unluckily) developed acute cholecystitis and needed emergency surgery, then again there are perhaps the inevitable side-effects of a lot more drugs (anesthetics included).

Therefore one has to weigh the advantages of undergoing a HIDA scan with CCK and the disadvantages of an unforeseen emergency gall bladder surgery.

Best wishes!

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