Classification Schema of Symptomatic Enterogastric Reflux Utilizing Sincalide Augmentation on Hepatobiliary Scintigraphy

A 60-y-old man with chronic right upper quadrant pain. All images are presented in 5-min time frames. Example of class-B EGR: EGR is present on postsincalide images only. Presincalide images show no EGR (A). Postsincalide images (B) show EGR onset at 20 min, which persists throughout remainder of imaging period (black arrows). Postsincalide imaging begins simultaneously with start of sincalide infusion. Presincalide imaging was stopped early at 50 min because patient left for restroom.

A 77-y-old woman with right upper quadrant pain. All images are presented in 5-min time frames. Example of class-C EGR: EGR is present on presincalide and postsincalide imaging, with increase in EGR intensity during postsincalide period. Presincalide images (A) demonstrate EGR that is definitively seen at 50 min (black arrow). Postsincalide images (B) show residual activity in stomach from presincalide imaging, with subsequent marked increase in activity at 18–24 min after initiation of sincalide infusion consistent with additional EGR (black arrow). Therefore, this patient experienced EGR pre- and postsincalide infusion and is grouped into class C. Postsincalide imaging begins simultaneously with start of sincalide infusion. GBEF curve is not shown to allow better display of pre- and postsincalide images.