Differential Diagnosis for Positive HIDA Scan Not Due to Acute Cholecystitis
Single Most Likely Diagnosis
- Chronic cholecystitis: This condition is a common cause of positive HIDA scan results, as the chronic inflammation can lead to decreased gallbladder function and reduced uptake of the radiotracer.
Other Likely Diagnoses
- Biliary dyskinesia: A motility disorder of the gallbladder that can cause decreased uptake on HIDA scan, often presenting with biliary-type pain.
- Postprandial gallbladder dysfunction: Some individuals may have gallbladder dysfunction that is only apparent after eating, which can lead to a positive HIDA scan.
- Gallbladder hydrops: A condition where the gallbladder becomes distended, often due to a blockage of the cystic duct, which can cause a positive HIDA scan.
Do Not Miss Diagnoses
- Sphincter of Oddi dysfunction: A condition that can cause biliary-type pain and abnormal HIDA scan results, which can be difficult to diagnose and requires specific treatment.
- Bile duct obstruction: Any obstruction of the bile ducts, such as from a stone or tumor, can cause a positive HIDA scan and requires prompt diagnosis and treatment to prevent serious complications.
- Mirizzi syndrome: A rare condition where a gallstone becomes impacted in the cystic duct and causes obstruction of the common bile duct, which can lead to severe complications if not recognized.
Rare Diagnoses
- Gallbladder torsion: A rare condition where the gallbladder twists, cutting off its blood supply, which can cause a positive HIDA scan and requires emergency surgical intervention.
- Porcelain gallbladder: A condition where the gallbladder wall becomes calcified, which can cause a positive HIDA scan and may be associated with an increased risk of gallbladder cancer.
- Gallbladder cancer: A rare but serious condition that can cause a positive HIDA scan, often presenting with non-specific symptoms and requiring prompt diagnosis and treatment.