The septum formation(web) of bile duct is an uncommon disease. Its rarity and vague symptoms result in delayed diagnosis. However, the increased use of endoscopic retrograde cholangiopancreatography(ERCP) and percutaneous transhepatic cholangiography(PTC) have resulted in greater awareness of this entity and understanding of its natural history as well as an increased frequency of diagnosis. We have experienced 4 cases of common bile duct web, which were associated with stones in the bile duct, confirmed by operation.
Bile Ducts ; Common Bile Duct* ; Delayed Diagnosis ; Diagnosis ; Natural History

BACKGROUND: Thalium 201(TI-201) has been a widely applied myocardial perfusion agent for the detection of coronary artery disease. however its low emission energy and long half-life make this agent suboptiomal for the examination of coronary artery disease. To circumvent the physical limitation of TI-201, a group of technetium 99m-labeled isonitril complex has been developed. Our study was done to examine the value of SPECT with 99mTc-HexaMIBI in estimating myocardial perfusion in patients with myocardial infarction. METHODS: We evaluated the sensitivity of SPECT with 99mTc-HexaMIBI in 29 patients with acute myocardial infarction. We also compared the severity and vascular territory of abnormal perfusion on SPECT scanning with severity of coronary artery stenosis, values of serum enzyme and sites in ECG. RESULTS: 1) There were 26 patients(90%) who showed perfusion defect, and 3 patients(10%) who showed normal perfusion in myocardial SPECT. The 3 patients with normal perfusion demonstrated non Q-wave infarction of ECG. 2) Among 23 patients performed coronary argiography, there were 19 patients(82%) who showed positive findings on myocardial SPECT and luminal narrowing above 50% on coronary angiogram, and there were 3 patients(13%) who showed significant coronary artery stenosis in spite of negative myocardial SPECT. 3) The grade of perfusion defect showed no significant difference between groups undergone thrombolytic therapy and groups not undergone thrombolytic therapy. 4) There was good correlation between the site of perfusion defect on SPECT and the site of infarction on ECG. CONCLUSION: We conclude that SPECT with 99mTc-HexaMIBI is a promising non invasive test for simultaneous diagnosis of myocardial infarction and evaluation of perfusion defect.
Coronary Artery Disease ; Coronary Stenosis ; Diagnosis ; Electrocardiography ; Half-Life ; Humans ; Infarction ; Myocardial Infarction* ; Perfusion ; Phenobarbital ; Technetium ; Technetium Tc 99m Sestamibi* ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon*