This Article Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Scott, B. B. Articles by Unsworth, J. Search for Related Content PubMed PubMed Citation Articles by Scott, B. B. Articles by Unsworth, J.

The initial investigation of jaundice in a district general hospital: a study of ultrasonography and hepatobiliary scintigraphy

B. B. Scott, M.D., M.R.C.P. J. A. Evans, M.Sc. ^* and J. Unsworth, M.Sc.

The Departments of Medicine and Medical Physics, Lincoln County Hospital and St. George's Hospital, Lincoln

Twenty-five jaundiced patients presenting to a district general hospital were investigated by both ultrasonography (performed by a medical physicist) and hepatobiliary scintigraphy using ⁹⁹Tc^m-HIDA. Hepatobiliary scintigraphy was completely unable to distinguish medical from surgical jaundice. However, with mild jaundice—bilirubin < 100 µmol/1—the presence or absence of gall-bladder activity fairly accurately predicted the presence or absence of gall-bladder disease. Ultrasonography had three technical failures. Of the remaining 22 patients, medical jaundice was correctly predicted in nine of ten patients and surgical jaundice in eight of 12 patients. Erroneous results were only obtained from patients with mild jaundice, the accuracy being 100% in the 15 patients with serum bilirubin > 60 µmol/1. In a district general hospital ultrasonography is recommended as the investigation of first choice in jaundice, perhaps complemented by hepatobiliary scintigraphy when the jaundice is mild.

^* Present address: Department of Medical Physics, C & A General Hospital, Bangor.

Present address: Department of Medical Physics, Barnsley General Hospital.

Received for publication October 1, 1979. Revision received January 1, 1980.

This article has been cited by other articles:

				B. B. Frank Clinical Evaluation of Jaundice: A Guideline of the Patient Care Committee of the American Gastroenterological Association JAMA, December 1, 1989; 262(21): 3031 - 3034. [Abstract] [PDF]