Precise Localization of a Bile Leak with Hepatobiliary Scintigraphy

Abstract

Hepatobiliary scintigraphy (HBS) is widely used modality to diagnose biliary injury. In patients with a history of trauma or surgery, the common presentations of bile leaks on HBS are a progressive collection of radiotracer outside of the biliary system. However precise localization of a bile leak is usually not conveyed by non-invasive techniques including CT or Ultrasound (US) or even HBS. This case study of a patient with liver trauma demonstrates a direct bile leak sign leading to recognition of an exact bile leakage site from the left intrahepatic duct. This diagnosis helped clinicians perform less invasive management.