Left Hepatic and Common Hepatic Ductal Bile Leaks Demonstrated by Tc-99m HIDA Scan and Percutaneous Transhepatic Cholangiogram

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Cholescintigraphy provides a sensitive means of diagnosing biliary leaks in the posttraumatic or postsurgical patient. After cholecystectomy, leaks are usually demonstrated in the gallbladder fossa or secondary to iatrogenic disruption of the common bile duct. The authors present a case of postcholecystectomy bile leak presumably secondary to rupture of an iatrogenically obstructed biliary system, with a relatively distal leak occurring at the junction of the left hepatic and common hepatic ducts (as well as another more proximal leak). Percutaneous transhepatic cholangiogram provides exact anatomic correlation.

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